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General NPI Number Information
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NPI Number | 1982386447
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Entity Type | Organization
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Legal Business Name | INNOVATIVE SOCIAL SOLUTIONS LLC
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 92 COMMONWEALTH AVE
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City | DEDHAM
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State | MA
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Zip | 02026-1425
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Country | US
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Telephone | 617-971-8332
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Fax |
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Provider Business Mailing Address
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Address Line | 92 COMMONWEALTH AVE
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City | DEDHAM
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State | MA
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Zip | 02026-1425
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Country | US
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Telephone | 617-971-8332
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | HANNAH CONLEY
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Credential | MA, MSSA, DBH, LICSW
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Telephone | 440-991-6623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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