Provider Demographics
NPI:1598478067
Name:INTEGRATED THERAPY AND RECOVERY INC
Entity Type:Organization
Organization Name:INTEGRATED THERAPY AND RECOVERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:LERZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-458-6406
Mailing Address - Street 1:12030 DONNER PASS RD STE 1-433
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-0449
Mailing Address - Country:US
Mailing Address - Phone:408-458-6406
Mailing Address - Fax:
Practice Address - Street 1:3880 S BASCOM AVE STE 216
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2675
Practice Address - Country:US
Practice Address - Phone:408-458-6404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty