Provider Demographics
NPI:1679934251
Name:INTEGRAL COMMUNITY SOLUTIONS INSTITUTE
Entity Type:Organization
Organization Name:INTEGRAL COMMUNITY SOLUTIONS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:559-497-5056
Mailing Address - Street 1:1065 S ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1406
Mailing Address - Country:US
Mailing Address - Phone:559-497-5056
Mailing Address - Fax:
Practice Address - Street 1:1065 S ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1406
Practice Address - Country:US
Practice Address - Phone:559-497-5056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health