Provider Demographics
NPI:1982375150
Name:INNOVATIONS INTERNATIONAL CHARTER SCHOOL OF NEVADA
Entity Type:Organization
Organization Name:INNOVATIONS INTERNATIONAL CHARTER SCHOOL OF NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-373-5260
Mailing Address - Street 1:1600 E OAKEY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3334
Mailing Address - Country:US
Mailing Address - Phone:702-216-4337
Mailing Address - Fax:702-216-4353
Practice Address - Street 1:1600 E OAKEY BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3334
Practice Address - Country:US
Practice Address - Phone:702-216-4337
Practice Address - Fax:702-216-4353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty