Healthcare Provider Details

I. General information

NPI: 1811608870
Provider Name (Legal Business Name): INNOVATIVE SOLUTIONS 4 U INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12813 OLD FORT RD
FORT WASHINGTON MD
20744-2876
US

IV. Provider business mailing address

12813 OLD FORT RD
FORT WASHINGTON MD
20744-2876
US

V. Phone/Fax

Practice location:
  • Phone: 301-250-4116
  • Fax:
Mailing address:
  • Phone: 301-250-4116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. KEITH EUGENE MCDANIEL SR.
Title or Position: CEO
Credential:
Phone: 202-709-2728