Provider Demographics
NPI:1851699219
Name:INTEGRATED PSYCHOTHERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:INTEGRATED PSYCHOTHERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:O
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-331-1200
Mailing Address - Street 1:PO BOX 540594
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-0594
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2121 MAIN ST
Practice Address - Street 2:STE. 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-4360
Practice Address - Country:US
Practice Address - Phone:214-331-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PSYCHOTHERAPUETIC SERVICES OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-09
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health