Provider Demographics
NPI:1326448986
Name:INNOVATIVE HEALTHCARE RESOURCES, INC.
Entity Type:Organization
Organization Name:INNOVATIVE HEALTHCARE RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-728-5788
Mailing Address - Street 1:6 PLEASANT ST
Mailing Address - Street 2:211
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5100
Mailing Address - Country:US
Mailing Address - Phone:301-728-5788
Mailing Address - Fax:188-833-4611
Practice Address - Street 1:6 PLEASANT ST
Practice Address - Street 2:211
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5100
Practice Address - Country:US
Practice Address - Phone:301-728-5788
Practice Address - Fax:188-833-4611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-01
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health