Healthcare Provider Details

I. General information

NPI: 1871647792
Provider Name (Legal Business Name): INNOVATIVE SOLUTIONS ADDICTION TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 9TH ST STE 102
SALINA KS
67401-3894
US

IV. Provider business mailing address

300 S 9TH ST STE 102
SALINA KS
67401-3894
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-9200
  • Fax: 785-452-9202
Mailing address:
  • Phone: 785-452-9200
  • Fax: 785-452-9202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN POPE
Title or Position: CEO
Credential:
Phone: 785-452-9200