Provider Demographics
NPI:1417253279
Name:INTEGRATIVE CARE
Entity Type:Organization
Organization Name:INTEGRATIVE CARE
Other - Org Name:PROGRESSIVE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-455-1772
Mailing Address - Street 1:2 CHARLES ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-2269
Mailing Address - Country:US
Mailing Address - Phone:401-455-1772
Mailing Address - Fax:401-455-1771
Practice Address - Street 1:2 CHARLES ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2269
Practice Address - Country:US
Practice Address - Phone:401-455-1772
Practice Address - Fax:401-455-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty