Provider Demographics
NPI:1255364402
Name:INTEGRATED HEALTH SERVICES,INC
Entity type:Organization
Organization Name:INTEGRATED HEALTH SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOERHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-920-8465
Mailing Address - Street 1:PO BOX 7265
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72217-7265
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 STUTTGART HWY
Practice Address - Street 2:
Practice Address - City:ENGLAND
Practice Address - State:AR
Practice Address - Zip Code:72046-2440
Practice Address - Country:US
Practice Address - Phone:501-842-2771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148307742Medicaid
AR148307742Medicaid