NPIMap

Organization Active NPI

Innovative Community Solutions, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Salem, VA
National Provider Identifier
1891752879
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
759 Issued in VA
Legal business name
INNOVATIVE COMMUNITY SOLUTIONS, INC.
Practice address
799 Union St
Salem, VA 24153-5122
Phone
(540) 293-2449
NPI assigned
Apr 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Authorized official

Name
Mr. Carl Miller III
Title
President
Phone
(540) 293-2449

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 759-02008 VA
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 759 VA Primary

Addresses

Primary practice location

799 Union St
Salem, VA 24153-5122

Mailing address

799 Union St
Salem, VA 24153-5122
Phone (540) 293-2449

Other identifiers 1

IdentifierTypeStateIssuer
010134242MedicaidVA

National Provider Directory

National Provider Directory
Tax ID family
Innovative Community Solutions Inc2 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": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1891752879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 UNION ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241535122",
            "telephone_number": "540-293-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 UNION ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241535122",
            "telephone_number": "540-293-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE COMMUNITY SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-293-2449",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "VA",
            "license": "759-02008",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010134242",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; 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.