Innovative Learning Group

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1-10-7128 Issued in NJ

Legal business name

INNOVATIVE LEARNING GROUP

Practice address

29 Garden Ave
Hawthorne, NJ 07506-1518

Phone

(973) 886-8768

NPI assigned

Jan 20, 2011

Organization subpart

No

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

Authorized official

Name

Maricruz Castillo

Title

Executive Director

Phone

(973) 886-8768

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1851696983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075070396",
            "telephone_number": "973-886-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 GARDEN AVE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075061518",
            "telephone_number": "973-886-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE LEARNING GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "MARICRUZ",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "973-886-8768"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "1-10-7128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.