INNOVATIVE LIFESTYLES, INC – NPI #1730615717
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

INNOVATIVE LIFESTYLES, INC is a community based residential treatment facility located in WATERFORD TOWNSHIP, MI. NPPES has assigned the NPI number 1730615717 to INNOVATIVE LIFESTYLES, INC on May 11, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for INNOVATIVE LIFESTYLES, INC below.

NPI Profile for
INNOVATIVE LIFESTYLES, INC

NPI Number
1730615717
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
INNOVATIVE LIFESTYLES, INC
Primary location
5490 DIXIE HWY
SUITE 1
WATERFORD TOWNSHIP, MI 48329
Phone: (248) 623-8898 Fax: (248) 623-8899
Mailing address
PO BOX 1258
CLARKSTON, MI 48347
Phone: (248) 623-8898 Fax: (248) 623-8899
Organization Subpart
No
Authorized Official
PAMELA HURLEY
EXECUTIVE DIRECTOR
Phone: (248) 623-8898
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
MI AS630279392

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.