Provider Demographics
NPI:1902837156
Name:INTERHEALTH, INC
Entity Type:Organization
Organization Name:INTERHEALTH, INC
Other - Org Name:THE CEDARS HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GM
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:FARAHMAND
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:972-720-1000
Mailing Address - Street 1:PO BOX 800699
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75380-0699
Mailing Address - Country:US
Mailing Address - Phone:972-720-1000
Mailing Address - Fax:972-720-0600
Practice Address - Street 1:2000 OLD HICKORY TRL
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2242
Practice Address - Country:US
Practice Address - Phone:972-298-7323
Practice Address - Fax:972-709-0581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000779283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX454065Medicare ID - Type Unspecified