MEDICARE: INNOVATIVE RESOURCE GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427180488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE RESOURCE GROUP, LLC

Provider Business Mailing Address
First Line	:	44 SOUTH BORADWAY
Second Line	:	SUITE 1200
City	:	WHITE PLAINS
State	:	NY
Zip	:	10601
Country	:	US
Telephone Number	:	800-305-3720
Fax Number	:	914-288-4605

Provider Business Practice Location Address
First Line	:	1680 PHOENIX BLVD
Second Line	:	SUITE 200
City	:	ATLANTA
State	:	GA
Zip	:	30349-5576
Country	:	US
Telephone Number	:	800-305-3720
Fax Number	:

Authorized Official
Title or Position	:	CORPORATE SECRETARY/GENERAL COUNSEL
Name	:	JOYCE TICHY
Credential	:
Telephone Number	:	914-288-4795

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/06/2009

Similar Medicare Providers

1518708072 — MANOUCHKA FLEURINORD DDS
Practice Location Address:

4718 ASHFORD DUNWOODY RD
ATLANTA, GA
30338-5576

Practice Phone: 770-625-1968
Practice Fax:

1003770033 — LAKIJA RIDLEY
Practice Location Address:

5617 WAVERLY PARK
ATLANTA, GA
30349-2725

Practice Phone: 404-323-5088
Practice Fax:

1376406256 — GUEST HOUSE 1 INC
Practice Location Address:

3890 STONEWALL TELL RD
ATLANTA, GA
30349-1415

Practice Phone: 770-703-4825
Practice Fax:

1982142808 — MARTELL HAWKINS PMHNP
Practice Location Address:

5454 YORKTOWNE DR
ATLANTA, GA
30349-5317

Practice Phone: 470-344-8719
Practice Fax: 470-264-2650

1578427019 — MAKYRA FARMER
Practice Location Address:

1800 PHOENIX BLVD STE 400
ATLANTA, GA
30349-5560

Practice Phone: 888-329-4535
Practice Fax:

1760346092 — MICHELLE NICOLE NICHOLS
Practice Location Address:

5625 SABLE BAY PT
ATLANTA, GA
30349-8812

Practice Phone: 470-213-1919
Practice Fax:

Directions to “INNOVATIVE RESOURCE GROUP, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.