Provider Demographics
NPI:1841736089
Name:INTEGRATIVE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:INTEGRATIVE HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-843-9338
Mailing Address - Street 1:3420 BRISTOL ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-7170
Mailing Address - Country:US
Mailing Address - Phone:714-843-9338
Mailing Address - Fax:
Practice Address - Street 1:3420 BRISTOL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7170
Practice Address - Country:US
Practice Address - Phone:714-843-9338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty