Provider Demographics
NPI:1588323539
Name:INNOVATIVE PSYCHIATRY CENTER INC
Entity type:Organization
Organization Name:INNOVATIVE PSYCHIATRY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BELLIVEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-997-1889
Mailing Address - Street 1:132 DRINKWATER RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON FALLS
Mailing Address - State:NH
Mailing Address - Zip Code:03844-2424
Mailing Address - Country:US
Mailing Address - Phone:603-997-1889
Mailing Address - Fax:
Practice Address - Street 1:132 DRINKWATER RD
Practice Address - Street 2:
Practice Address - City:HAMPTON FALLS
Practice Address - State:NH
Practice Address - Zip Code:03844-2424
Practice Address - Country:US
Practice Address - Phone:603-997-1889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health