Provider Demographics
NPI:1205434875
Name:INTEGRATED HEALTH CENTER
Entity type:Organization
Organization Name:INTEGRATED HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LI
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DIPL, AC
Authorized Official - Phone:803-750-0040
Mailing Address - Street 1:128 LEISURE LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-4125
Mailing Address - Country:US
Mailing Address - Phone:803-750-0040
Mailing Address - Fax:
Practice Address - Street 1:128 LEISURE LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-4125
Practice Address - Country:US
Practice Address - Phone:803-750-0040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center