Provider Demographics
NPI:1255675138
Name:INTEGRATED CARE LLC
Entity Type:Organization
Organization Name:INTEGRATED CARE LLC
Other - Org Name:INTEGRATED REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:WASHKUHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-502-1819
Mailing Address - Street 1:4832 S 24TH ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-2703
Mailing Address - Country:US
Mailing Address - Phone:402-502-1819
Mailing Address - Fax:402-315-9994
Practice Address - Street 1:4832 S 24TH STREET
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-2703
Practice Address - Country:US
Practice Address - Phone:402-502-1819
Practice Address - Fax:402-315-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-16
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1469111N00000X
NE2828225100000X
261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty