Innovation Health System, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

INNOVATION HEALTH SYSTEM, LLC

Practice address

2138 Espey CT Ste 1
Crofton, MD 21114-2495

Phone

(443) 470-7916

Fax

(443) 470-7718

NPI assigned

Aug 9, 2024

Organization subpart

No

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

Authorized official

Name

Richard Nkwetta

Title

Owner

Phone

(443) 470-7916

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1548091838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 ESPEY CT STE 1",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142495",
            "telephone_number": "443-470-7916",
            "fax_number": "443-470-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 ESPEY CT STE 1",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142495",
            "telephone_number": "443-470-7916",
            "fax_number": "443-470-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION HEALTH SYSTEM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "NKWETTA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-470-7916"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Integrated Fitness and Rehab, LLC
• Into the Gray Counseling and Consulting LLC
• Intuitive Consulting and Training LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Crofton, MD
• Providers in Crofton, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.