Organization
INNOVATIVE CONSULTING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARDENA JOHNSON (CHIEF EXECUTIVE OFFICER)
(678) 467-2778
Entity
Organization
Contact information
Practice address
60 LIGHTWOOD DRIVE, COVINGTON, GA 30016
(678) 342-7037
(678) 342-9632
Mailing address
60 LIGHTWOOD DRIVE, COVINGTON, GA 30016
(678) 342-7037
(678) 342-9632
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
02/03/2009
Last updated
02/03/2009
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