Organization
INNOVATIVE MIND SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEBUKOLA REBECCA ADEBAYO (CEO)
(862) 300-9408
Entity
Organization
Contact information
Practice address
27 MYRTLE AVE APT 2, IRVINGTON, NJ 07111-3319
(862) 300-9408
Mailing address
27 MYRTLE AVE APT 2, IRVINGTON, NJ 07111-3319
(862) 300-9408
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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