# INNOVATIVE HEALTH CARE INSTITUTE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942723028
- **Authorized official:** DR. CSHANYSE AVRIL ALLEN DNP, MSN, RN (CEO)
- **Authorized official phone:** (706) 705-2033

## Contact information

- **Practice address:** 100 SEAGRAVES DR STE 1, ATHENS, GA 30605-2492
- **Practice address phone:** (706) 705-2033
- **Practice address fax:** (706) 850-8005
- **Mailing address:** 100 SEAGRAVES DR STE 1, ATHENS, GA 30605-2492
- **Mailing address phone:** (706) 705-2033
- **Mailing address fax:** (706) 850-8005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | RN146812 | GA | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/20/2017
- **Last updated:** 08/26/2021