Provider Demographics
NPI:1003451469
Name:WHITE TIGER INTEGRATED SERVICES, LLC
Entity Type:Organization
Organization Name:WHITE TIGER INTEGRATED SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DACE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TAPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DBH, LPC, NCC
Authorized Official - Phone:602-637-7361
Mailing Address - Street 1:67 E WELDON AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2044
Mailing Address - Country:US
Mailing Address - Phone:603-637-7361
Mailing Address - Fax:
Practice Address - Street 1:67 E WELDON AVE STE 220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2044
Practice Address - Country:US
Practice Address - Phone:603-637-7361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty