Organization
INNOVATIVE COUNSELING & CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN N MILLER JR. (CHIEF EXECUTIVE OFFICER)
(901) 276-0220
Entity
Organization
Contact information
Practice address
1455 POPLAR AVE, MEMPHIS, TN 38104-2934
(901) 276-0220
(901) 276-0225
Mailing address
1455 POPLAR AVE, MEMPHIS, TN 38104-2934
(901) 276-0220
(901) 276-0225
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
02/22/2007
Last updated
03/30/2011
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