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General NPI Number Information
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NPI Number | 1194002097
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Entity Type | Organization
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Legal Business Name | INNOVATIVE OPPORTUNITIES, INC.
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Dates
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Enumeration Date | 11/07/2011
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Last Update Date | 11/07/2011
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Provider Practice Location Address
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Address Line | 667 LAKEVIEW PLAZA BLVD STE D
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City | WORTHINGTON
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State | OH
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Zip | 43085-4781
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Country | US
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Telephone | 614-436-0854
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Fax | 614-436-0022
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Provider Business Mailing Address
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Address Line | 667 LAKEVIEW PLAZA BLVD STE D
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City | WORTHINGTON
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State | OH
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Zip | 43085-4781
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Country | US
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Telephone | 614-436-0854
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Fax | 614-436-0022
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. GAIL BLOOM
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Credential |
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Telephone | 614-436-0854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 899293
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License Number State | OH
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