Organization
INNOVATIVE PROGRAMMING ASSOCIATES, INC.
Active
Organization
INNOVATIVE PROGRAMMING ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE COLEY (BILLING SUPERVISOR)
(910) 483-0734
Entity
Organization
Contact information
Practice address
131 HAY ST, SUITE 201, FAYETTEVILLE, NC 28301-5649
(910) 484-1869
(910) 483-8515
Mailing address
111 LAMON ST., FAYETTEVILLE, NC 28301
(910) 483-0734
(910) 483-9403
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NC
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
NC
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NC
324500000X
Substance Abuse Rehabilitation Facility
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300765
—
NC
05
—
8300765B
—
NC
Enumeration date
03/06/2007
Last updated
08/23/2007
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