Organization
INNOVATIVE COMMUNITY SOLUTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL MILLER III (PRESIDENT)
(540) 293-2449
Entity
Organization
Contact information
Practice address
799 UNION ST, SALEM, VA 24153-5122
(540) 293-2449
Mailing address
799 UNION ST, SALEM, VA 24153-5122
(540) 293-2449
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
759-02008
VA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
759
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010134242
—
VA
Enumeration date
04/26/2006
Last updated
09/22/2016
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