Organization
INNOVATIVE THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZACCHEAUS ELEY (OWNER)
(910) 237-5456
Entity
Organization
Contact information
Practice address
755 S MAIN ST, RAEFORD, NC 28376-3238
(910) 237-5456
(910) 848-0492
Mailing address
916 HAY ST, FAYETTEVILLE, NC 28305-5314
(910) 237-5456
(910) 848-0492
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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