NPIMap

Organization Active NPI

Innovative Mind Services

  • Respite Care
  • Irvington, NJ
National Provider Identifier
1336876341
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Legal business name
INNOVATIVE MIND SERVICES
Practice address
27 Myrtle Ave Apt 2
Irvington, NJ 07111-3319
Phone
(862) 300-9408
NPI assigned
Aug 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Adebukola Rebecca Adebayo
Title
Ceo
Phone
(862) 300-9408

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X Primary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

27 Myrtle Ave Apt 2
Irvington, NJ 07111-3319

Mailing address

27 Myrtle Ave Apt 2
Irvington, NJ 07111-3319
Phone (862) 300-9408

National Provider Directory

National Provider Directory
Tax ID family
Innovative Mind Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1336876341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MYRTLE AVE APT 2",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113319",
            "telephone_number": "862-300-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MYRTLE AVE APT 2",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113319",
            "telephone_number": "862-300-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MIND SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "ADEBAYO",
        "authorized_official_first_name": "ADEBUKOLA",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "862-300-9408"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.