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General NPI Number Information
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NPI Number | 1770098451
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Entity Type | Organization
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Legal Business Name | INNOVATIVE RESOURCE SERVICES, INC.
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Dates
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Enumeration Date | 12/04/2017
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 271 GEORGE WYNN RD
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City | PALMETTO
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State | GA
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Zip | 30268-8579
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Country | US
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Telephone | 404-396-5390
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Fax | 770-463-1561
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Provider Business Mailing Address
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Address Line | 271 GEORGE WYNN RD
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City | PALMETTO
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State | GA
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Zip | 30268-8579
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. VIVIA COLLINS
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Credential |
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Telephone | 404-396-5390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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