Provider Demographics
NPI:1467823666
Name:INTEGRATED BEHAVIORAL HEALTH CARE INC
Entity Type:Organization
Organization Name:INTEGRATED BEHAVIORAL HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:W
Authorized Official - Middle Name:VERNON
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-374-8140
Mailing Address - Street 1:444 HIGHLAND AVE NE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1301
Mailing Address - Country:US
Mailing Address - Phone:678-374-8140
Mailing Address - Fax:
Practice Address - Street 1:444 HIGHLAND AVE NE
Practice Address - Street 2:SUITE 320
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1301
Practice Address - Country:US
Practice Address - Phone:678-374-8140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health