Provider Demographics
NPI:1861829384
Name:INTEGRATIVE HEALTH LLC
Entity Type:Organization
Organization Name:INTEGRATIVE HEALTH LLC
Other - Org Name:SCOTT FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:GALIOTO
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-663-2225
Mailing Address - Street 1:1491 DENVER AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5227
Mailing Address - Country:US
Mailing Address - Phone:970-663-2225
Mailing Address - Fax:970-593-6748
Practice Address - Street 1:1491 DENVER AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5227
Practice Address - Country:US
Practice Address - Phone:970-663-2225
Practice Address - Fax:970-593-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO208100000X
CO34072208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01340728Medicaid
CO01340728Medicaid