Innovative Minds LLC

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

INNOVATIVE MINDS LLC

Practice address

27 Myrtle Ave Apt 2
Irvington, NJ 07111-3319

Phone

(862) 300-9408

NPI assigned

Jul 18, 2022

Organization subpart

No

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 4

Addresses

Other names 1

• Innovative Minds Doing business as

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1649905274",
    "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 MINDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "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": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Minds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Innovative Mind Services
• Irvington Adult Day Care Center
• Irvington Board of Education
• Irvington Counseling Center, Inc.
• Irvington Department of Health and Welfare
• Irvington Emergent Care

• Child Intellectual and/or Developmental Disabilities Respite Care in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.