Provider Demographics
NPI:1831521533
Name:INNOVATIVE OPTIONS INCORPORATED
Entity type:Organization
Organization Name:INNOVATIVE OPTIONS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:NUMITAL
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-580-5678
Mailing Address - Street 1:3915 CASCADE RD SW STE T-138
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-2009
Mailing Address - Country:US
Mailing Address - Phone:404-692-0818
Mailing Address - Fax:
Practice Address - Street 1:3915 CASCADE RD SW STE T-138
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2009
Practice Address - Country:US
Practice Address - Phone:844-580-5678
Practice Address - Fax:678-288-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty