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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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