Provider Demographics
NPI:1790074714
Name:INTEGRATIONS TREATMENT CENTER
Entity Type:Organization
Organization Name:INTEGRATIONS TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:WINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:2168-490-1215
Mailing Address - Street 1:28700 EUCLID AVE
Mailing Address - Street 2:#120
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-2527
Mailing Address - Country:US
Mailing Address - Phone:440-943-7607
Mailing Address - Fax:440-943-7803
Practice Address - Street 1:28700 EUCLID AVE
Practice Address - Street 2:#120
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092-2527
Practice Address - Country:US
Practice Address - Phone:440-943-7607
Practice Address - Fax:440-943-7803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty