NPIMap

Organization Active NPI

Innova Recovery, PLLC

  • Adult Mental Health Clinic/Center
  • Milwaukee, WI
National Provider Identifier
1295461580
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
INNOVA RECOVERY, PLLC
Practice address
5215 N Ironwood Rd Ste 202
Milwaukee, WI 53217-4908
Phone
(210) 254-3618
Fax
(210) 881-9022
NPI assigned
Jul 28, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Kasi Howard, PSYD
Title
Owner
Phone
(210) 254-3618

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

5215 N Ironwood Rd Ste 202
Milwaukee, WI 53217-4908

Mailing address

1842 Lockhill Selma Rd
San Antonio, TX 78213-1559
Phone (210) 838-0090

Other names 1

  • Innova Recovery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Innova Recovery PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1295461580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1842 LOCKHILL SELMA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131559",
            "telephone_number": "210-838-0090",
            "fax_number": "210-881-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N IRONWOOD RD STE 202",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532174908",
            "telephone_number": "210-254-3618",
            "fax_number": "210-881-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVA RECOVERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "KASI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-254-3618",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innova Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.