Provider Demographics
NPI:1437220969
Name:INTEGRATED HEALTHCARE L.L.P.
Entity Type:Organization
Organization Name:INTEGRATED HEALTHCARE L.L.P.
Other - Org Name:HAZEL STREET RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-227-7305
Mailing Address - Street 1:1405 N PIERCE ST
Mailing Address - Street 2:STE. 202
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-5349
Mailing Address - Country:US
Mailing Address - Phone:501-227-7305
Mailing Address - Fax:501-227-4669
Practice Address - Street 1:1217 HAZEL ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-4432
Practice Address - Country:US
Practice Address - Phone:903-791-0385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children