Organization
INNOVATIVE HEALTH SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICARDO DAVID TILLERY MBA, LCSW, SAP (CEO)
(517) 703-3387
Entity
Organization
Contact information
Practice address
3721 W MICHIGAN AVE STE 200, LANSING, MI 48917-3600
(517) 515-6176
Mailing address
3721 W MICHIGAN AVE STE 200, LANSING, MI 48917-3600
(517) 515-6176
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QC1800X
Corporate Health Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/07/2020
Last updated
07/07/2020
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