Innovative Addiction Services

NPI #1356931513 in Lansing, Michigan

Provider Information

NPI Number: 1356931513
Entity Type: Organization
Organization Name: Innovative Addiction Services
Subpart: Yes (part of a larger organization)
Parent Organization: INNOVATIVE HEALTH SYSTEMS
Primary Specialty: Clinic/Center - Rehabilitation, Substance Use Disorder
Enumeration Date: Jan 21, 2021
Last Updated: Jan 21, 2021

Practice Location

Address: 3721 W MICHIGAN AVE STE 200
City: Lansing
State: Michigan
ZIP Code: 48917-3600
Phone: (517) 515-6176

Authorized Official

Name: MR. RICARDO DAVID TILLERY, MBA, LMSW, CAADC
Title: CEO
Phone: (517) 703-3387

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Clinic/Center - Community Health — Community Health	261QC1500X
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X	Primary

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