Organization
INNOVATIVE WELLNESS SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGINA FIORENTINO EDD, LCASA (LCASA COUNSELOR/TCM SUPERVISOR)
(917) 841-7842
Entity
Organization
Contact information
Practice address
2520 IMPATIEN DR, CHARLOTTE, NC 28215-7739
(917) 841-7842
Mailing address
2520 IMPATIEN DR, CHARLOTTE, NC 28215-7739
(917) 841-7842
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
11/14/2025
Last updated
11/14/2025
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