NPI 1184923054
Innovative Support Services, LLC
Practice location
- Address
- 310 Modest St, Lakeland, FL 33805-3123
- Phone
- (863) 904-8820
- Fax
- (866) 271-5349
- Mailing address
- PO Box 2253, Eaton Park, FL 33840-2253
Authorised official
- Name
- Stephanie Kirnes
- Title
- Executive Director
- Phone
- (863) 904-8820
Registered specialties (5)
Case Management Agency
Primary
Counselor
Social Worker
Public Health or Welfare Agency
Supports Brokerage Agency
Registry record
- NPI
- 1184923054
- Entity type
- Organization
- NPI issued
- 18 Mar 2011
- Record last updated
- 18 Mar 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.