Provider Demographics
NPI:1245846708
Name:INTEGRATED ENERGIES LLC
Entity type:Organization
Organization Name:INTEGRATED ENERGIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO & OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TEISHA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, NBCC, LPCC
Authorized Official - Phone:505-412-9834
Mailing Address - Street 1:3000 TRINITY DR APT 59
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2340
Mailing Address - Country:US
Mailing Address - Phone:505-412-9834
Mailing Address - Fax:
Practice Address - Street 1:3000 TRINITY DR APT 59
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2340
Practice Address - Country:US
Practice Address - Phone:505-412-9834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2021-07-13
Deactivation Date:2021-03-26
Deactivation Code:
Reactivation Date:2021-06-18
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty