Provider Demographics
NPI:1043469380
Name:INTEGRAL ENRICHMENT SERVICES
Entity Type:Organization
Organization Name:INTEGRAL ENRICHMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISKA
Authorized Official - Middle Name:
Authorized Official - Last Name:IMBERTI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-623-2162
Mailing Address - Street 1:72 GUY LOMBARDO AVE
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3742
Mailing Address - Country:US
Mailing Address - Phone:516-623-2162
Mailing Address - Fax:631-888-0431
Practice Address - Street 1:72 GUY LOMBARDO AVE
Practice Address - Street 2:SUITE # 2
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3742
Practice Address - Country:US
Practice Address - Phone:516-623-2162
Practice Address - Fax:631-888-0431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty