Provider Demographics
NPI:1013393396
Name:INTEGRATIVE CAP HEALTH PRACTICES
Entity Type:Organization
Organization Name:INTEGRATIVE CAP HEALTH PRACTICES
Other - Org Name:ESSENCE IN NUTRITION CONSULTANTS CAPHP LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONIE
Authorized Official - Middle Name:V
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ND, NMD
Authorized Official - Phone:404-259-2206
Mailing Address - Street 1:230 CARRIAGE STATION CIR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4655
Mailing Address - Country:US
Mailing Address - Phone:404-259-2206
Mailing Address - Fax:
Practice Address - Street 1:990 HOLCOMB BRIDGE RD
Practice Address - Street 2:230
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-6203
Practice Address - Country:US
Practice Address - Phone:404-259-2206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty