Provider Demographics
NPI:1932689353
Name:INTEGRATED HEALTH RESOURCES
Entity Type:Organization
Organization Name:INTEGRATED HEALTH RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WALKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-494-4999
Mailing Address - Street 1:8737 COLESVILLE RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3921
Mailing Address - Country:US
Mailing Address - Phone:301-583-5191
Mailing Address - Fax:301-850-6910
Practice Address - Street 1:8737 COLESVILLE RD STE 310
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3921
Practice Address - Country:US
Practice Address - Phone:301-583-5195
Practice Address - Fax:202-899-4222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IVAN WALKS & ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-15
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC024653584Medicaid