Organization
INNOVATIVE MAT SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GOODLETT (CEO)
(828) 734-9979
Entity
Organization
Contact information
Practice address
2215 AMBASSADOR RD NE APT 37, ALBUQUERQUE, NM 87112-2767
(828) 734-9979
Mailing address
2215 AMBASSADOR RD NE APT 37, ALBUQUERQUE, NM 87112-2767
(828) 734-9979
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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