Provider Demographics
NPI:1598464042
Name:IT IS WELL INTEGRATIVE PARTNERS
Entity Type:Organization
Organization Name:IT IS WELL INTEGRATIVE PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCASLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:860-510-2842
Mailing Address - Street 1:282 MAIN STREET EXT STE A3
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4467
Mailing Address - Country:US
Mailing Address - Phone:860-270-0506
Mailing Address - Fax:
Practice Address - Street 1:282 MAIN STREET EXT STE A3
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4467
Practice Address - Country:US
Practice Address - Phone:860-270-0506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008115380Medicaid
1295443604OtherNPI
1912592601OtherNPI
CT008101186Medicaid