Provider Demographics
NPI:1073117099
Name:INTEGRATIVE CARE LLC
Entity Type:Organization
Organization Name:INTEGRATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:813-784-5181
Mailing Address - Street 1:5620 E FOWLER AVE STE E
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-2373
Mailing Address - Country:US
Mailing Address - Phone:813-358-7912
Mailing Address - Fax:
Practice Address - Street 1:5620 E FOWLER AVE STE E
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-2373
Practice Address - Country:US
Practice Address - Phone:813-358-7912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty