Provider Demographics
NPI:1629255955
Name:INTEGRATED TREATMENT SERVICES LLC
Entity Type:Organization
Organization Name:INTEGRATED TREATMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SALLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CADC
Authorized Official - Phone:641-275-1119
Mailing Address - Street 1:303 S 2ND AVE W
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3712
Mailing Address - Country:US
Mailing Address - Phone:641-275-1119
Mailing Address - Fax:641-787-0063
Practice Address - Street 1:303 S 2ND AVE W
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3712
Practice Address - Country:US
Practice Address - Phone:641-275-1119
Practice Address - Fax:641-792-6251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1312251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health