Provider Demographics
NPI:1619374840
Name:INTEGRATIVE WOMENS SERVICES LLC/TOTALYOU WELLNESS
Entity Type:Organization
Organization Name:INTEGRATIVE WOMENS SERVICES LLC/TOTALYOU WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:FACISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-713-6032
Mailing Address - Street 1:19207 KELLY AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-8214
Mailing Address - Country:US
Mailing Address - Phone:561-713-6032
Mailing Address - Fax:
Practice Address - Street 1:19207 KELLY AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-8214
Practice Address - Country:US
Practice Address - Phone:561-713-6032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care