Provider Demographics
NPI:1851922629
Name:INTEGRATED HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:INTEGRATED HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VAUGHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-237-3097
Mailing Address - Street 1:281 MARTIN LUTHER KING JR ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:70443-2386
Mailing Address - Country:US
Mailing Address - Phone:985-606-2424
Mailing Address - Fax:985-606-2390
Practice Address - Street 1:281 MARTIN LUTHER KING JR ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:LA
Practice Address - Zip Code:70443-2386
Practice Address - Country:US
Practice Address - Phone:985-606-2424
Practice Address - Fax:985-606-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty