Provider Demographics
NPI:1871262022
Name:VAKEN INTEGRATED CARE LLC
Entity Type:Organization
Organization Name:VAKEN INTEGRATED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTACT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDVALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:833-825-3694
Mailing Address - Street 1:11816 INWOOD RD STE 70454
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-8011
Mailing Address - Country:US
Mailing Address - Phone:833-825-3694
Mailing Address - Fax:
Practice Address - Street 1:11816 INWOOD RD
Practice Address - Street 2:PMB 70454
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244
Practice Address - Country:US
Practice Address - Phone:833-825-3694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty