Organization
INNOVATIVE DAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONITA F. BULLOCK (BUSINESS MANAGER)
(301) 270-4750
Entity
Organization
Contact information
Practice address
6135 KANSAS AVE NE, WASHINGTON, DC 20011-1505
(202) 269-3853
(202) 269-3854
Mailing address
8484 GEORGIA AVE STE 900, SILVER SPRING, MD 20910-5604
(301) 270-4750
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/20/2018
Last updated
01/10/2019
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