Provider Demographics
| NPI: | 1235531872 |
|---|---|
| Name: | INFINITI SOLUTIONS GLOBAL LLC |
| Entity Type: | Organization |
| Organization Name: | INFINITI SOLUTIONS GLOBAL LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | LEO |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | PHILLIPS |
| Authorized Official - Suffix: | JR |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 843-245-7555 |
| Mailing Address - Street 1: | 3741 E HIGHWAY 76 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MULLINS |
| Mailing Address - State: | SC |
| Mailing Address - Zip Code: | 29574-7304 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 843-464-4005 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 4706 E HIGHWAY 76 |
| Practice Address - Street 2: | |
| Practice Address - City: | MULLINS |
| Practice Address - State: | SC |
| Practice Address - Zip Code: | 29574-7290 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 843-464-4005 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2014-09-25 |
| Last Update Date: | 2014-09-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| No | 320600000X | Residential Treatment Facilities | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 322D00000X | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children | |
| No | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | |
| No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
