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General NPI Number Information
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NPI Number | 1275610545
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Entity Type | Organization
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Legal Business Name | INNOVATIVE HEALTH SYSTEMS, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 7 HOLLAND AVE SECOND FLOOR
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City | WHITE PLAINS
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State | NY
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Zip | 10603-3317
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Country | US
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Telephone | 914-683-8050
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Fax | 914-683-8054
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Provider Business Mailing Address
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Address Line | 7 HOLLAND AVE SECOND FLOOR
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City | WHITE PLAINS
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State | NY
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Zip | 10603-3317
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Country | US
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Telephone | 914-683-8050
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Fax | 914-683-8054
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ROSS FISHMAN
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Credential | PH.D.
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Telephone | 914-683-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 060810830
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License Number State | NY
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