NPIMap

Organization Active NPI

Innovative Life Solutions, Inc.

  • Developmental Disabilities Clinic/Center
  • Washington, DC
National Provider Identifier
1275914095
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
INNOVATIVE LIFE SOLUTIONS, INC.
Practice address
3043 Bladensburg Rd NE
Washington, DC 20018-2233
Phone
(301) 270-4750
Fax
(301) 270-4754
NPI assigned
Jun 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. David A. Carrington
Title
President /Ceo
Phone
(301) 270-4750

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X TBA DC

Addresses

Primary practice location

3043 Bladensburg Rd NE
Washington, DC 20018-2233

Mailing address

6475 New Hampshire Ave
Suite 760
Hyattsville, MD 20783-3269
Phone (301) 270-4750

Other identifiers 1

IdentifierTypeStateIssuer
TBAMedicaidDC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
09D2025308Innovative Life Solutions3043 Bladensburg Rd NE, Washington, DC 20018Certificate of waiverJun 5, 2027

National Provider Directory

National Provider Directory
Tax ID family
Innovative Life Solutions Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1275914095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6475 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 760",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207833269",
            "telephone_number": "301-270-4750",
            "fax_number": "301-270-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 BLADENSBURG RD NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200182233",
            "telephone_number": "301-270-4750",
            "fax_number": "301-270-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE LIFE SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "CARRINGTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT /CEO",
        "authorized_official_telephone_number": "301-270-4750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "DC",
            "license": "TBA",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TBA",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.