Provider Demographics
NPI:1720433022
Name:INTEGRATED COMPREHENSIVE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:INTEGRATED COMPREHENSIVE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:239-935-5599
Mailing Address - Street 1:9400 GLADIOLUS DR
Mailing Address - Street 2:SUITE 340
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-6699
Mailing Address - Country:US
Mailing Address - Phone:239-935-5599
Mailing Address - Fax:239-313-5614
Practice Address - Street 1:9400 GLADIOLUS DR
Practice Address - Street 2:SUITE 340
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-6699
Practice Address - Country:US
Practice Address - Phone:239-935-5599
Practice Address - Fax:239-313-5614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty