Provider Demographics
NPI:1083065452
Name:INTEGRIS HEALTH
Entity Type:Organization
Organization Name:INTEGRIS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMISSIONS ACCESS COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRITTNY
Authorized Official - Middle Name:LATRICE
Authorized Official - Last Name:SAULS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-793-7885
Mailing Address - Street 1:2111 RIVERWALK DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2700
Mailing Address - Country:US
Mailing Address - Phone:405-793-7885
Mailing Address - Fax:
Practice Address - Street 1:2111 RIVERWALK DR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2700
Practice Address - Country:US
Practice Address - Phone:405-793-7885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731192765OtherCOMMUNITY HEALTH HMO,TRICARE AND HEALTHCHOICE