Provider Demographics
NPI:1609076579
Name:INNOVATIVE BEHAVIORAL SOLUTIONS INC.
Entity Type:Organization
Organization Name:INNOVATIVE BEHAVIORAL SOLUTIONS INC.
Other - Org Name:CARPE DIEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:THOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:702-485-6705
Mailing Address - Street 1:4525 SPRING MOUNTAIN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8751
Mailing Address - Country:US
Mailing Address - Phone:702-485-6705
Mailing Address - Fax:702-485-6706
Practice Address - Street 1:4525 SPRING MOUNTAIN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8751
Practice Address - Country:US
Practice Address - Phone:702-485-6705
Practice Address - Fax:702-485-6706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services