Organization
INNOVATIVE LIFE SOLUTIONS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONITA F BULLOCK (AUTHORIZED OFFICIAL)
(301) 270-4750
Entity
Organization
Contact information
Practice address
1703 FRANKFORD ST SE, WASHINGTON, DC 20020-6309
(301) 270-4750
Mailing address
8484 GEORGIA AVE STE 900, SILVER SPRING, MD 20910-5604
(301) 270-4750
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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