Provider Demographics
NPI:1013983535
Name:INTEGRACARE REHABILITATION AGENCY INC
Entity type:Organization
Organization Name:INTEGRACARE REHABILITATION AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUSATERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-330-8451
Mailing Address - Street 1:525 SE 6TH AVE
Mailing Address - Street 2:STE B
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5258
Mailing Address - Country:US
Mailing Address - Phone:561-330-8451
Mailing Address - Fax:561-330-8461
Practice Address - Street 1:1801 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1442
Practice Address - Country:US
Practice Address - Phone:954-531-1472
Practice Address - Fax:954-531-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
686696Medicare ID - Type Unspecified