Innovative Services, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

INNOVATIVE SERVICES, INC.

Practice address

445 S Madison St
Green Bay, WI 54301-4126

Phone

(920) 431-0962

Fax

(920) 884-1967

NPI assigned

Oct 7, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Kerry Blondheim

Title

Vice President of Administration

Phone

(920) 431-0962

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Innovative Wisconsin, LLC

  • Community/Behavioral Health Agency
  • Green Bay, WI
  • NPI 1871972349
  NPPES parent name

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1437433562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 SAN LUIS PL",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045211",
            "telephone_number": "920-431-0962",
            "fax_number": "920-431-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 S MADISON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014126",
            "telephone_number": "920-431-0962",
            "fax_number": "920-884-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "BLONDHEIM",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF ADMINISTRATION",
        "authorized_official_telephone_number": "920-431-0962",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Inspirit Wellness
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• Interim Healthcare of N E Wi Inc

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.