Provider Demographics
NPI:1205452794
Name:INNOVATIVE HEALTHCARE CONSULTANTS
Entity type:Organization
Organization Name:INNOVATIVE HEALTHCARE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:NITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VIJH-FAUTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-804-6268
Mailing Address - Street 1:746 S MAIN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-3352
Mailing Address - Country:US
Mailing Address - Phone:760-731-1334
Mailing Address - Fax:833-790-2628
Practice Address - Street 1:746 S MAIN AVE STE B
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3352
Practice Address - Country:US
Practice Address - Phone:760-731-1334
Practice Address - Fax:833-790-2628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite CareGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA374700177OtherHOME CARE ORGANIZATION NUMBER