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Organization

INNOVATIVE LIFE SOLUTIONS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BONITA F BULLOCK (BUSINESS MANAGER)
(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
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
TBA
DC

Other

Enumeration date
04/12/2018
Last updated
04/12/2018
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