| Innovative Healthcare Training, Inc. | |
|
2 Crain Hwy S Ste 2b Glen Burnie MD 21061-3526 | |
| (443) 410-3570 | |
| (443) 410-3592 |
| Full Name | Innovative Healthcare Training, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2 Crain Hwy S Ste 2b, Glen Burnie, Maryland |
| Authorized Official Name and Position | Crystal Greene (CEO) |
| Authorized Official Contact | 4434103570 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Healthcare Training, Inc. 2 Crain Hwy S Ste 2b Glen Burnie MD 21061-3526 Ph: (443) 410-3570 | Innovative Healthcare Training, Inc. 2 Crain Hwy S Ste 2b Glen Burnie MD 21061-3526 Ph: (443) 410-3570 |
| NPI Number | 1689376287 |
|---|---|
| Provider Enumeration Date | 03/20/2023 |
| Last Update Date | 03/20/2023 |
| Certification Date | 03/20/2023 |
| Medicare PECOS PAC ID | 0547624496 |
|---|---|
| Medicare Enrollment ID | O20230912001584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689376287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Crystal Greene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689184947 PECOS PAC ID: 6709148570 Enrollment ID: I20180315001517 |
| Provider Name | Lazare Shadzeka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760015010 PECOS PAC ID: 4789094822 Enrollment ID: I20230912001995 |
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