Provider Demographics
NPI:1770022311
Name:INNOVATIVE THERAPEUTIC SOLUTIONS
Entity Type:Organization
Organization Name:INNOVATIVE THERAPEUTIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-658-3346
Mailing Address - Street 1:2051 ROSA PARKS BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48216-1585
Mailing Address - Country:US
Mailing Address - Phone:313-658-3346
Mailing Address - Fax:
Practice Address - Street 1:155 W CONGRESS ST STE 306
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-3272
Practice Address - Country:US
Practice Address - Phone:313-658-3346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health