Provider Demographics
NPI:1326264359
Name:HEALTHCARE INNOVATIONS PRIVATE SERVICES
Entity type:Organization
Organization Name:HEALTHCARE INNOVATIONS PRIVATE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE,PRIVACY,& SAFETY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONASTIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-768-4373
Mailing Address - Street 1:3010 LYNDON B JOHNSON FWY STE 1100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2712
Mailing Address - Country:US
Mailing Address - Phone:800-379-1600
Mailing Address - Fax:903-537-8420
Practice Address - Street 1:7101 NW EXPRESSWAY STE 325
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-1594
Practice Address - Country:US
Practice Address - Phone:405-943-0094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251C00000X, 251J00000X, 385H00000X
OK7583251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100685770AMedicaid
OK100685770BMedicaid
OK100685770EMedicaid
OK100685770FMedicaid