Provider Demographics
NPI:1952798472
Name:INTEGRATED BEHAVIORAL HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:INTEGRATED BEHAVIORAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-257-3637
Mailing Address - Street 1:30100 TOWN CENTER DR
Mailing Address - Street 2:O - 431
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2064
Mailing Address - Country:US
Mailing Address - Phone:949-489-5564
Mailing Address - Fax:949-493-9359
Practice Address - Street 1:30100 TOWN CENTER DR
Practice Address - Street 2:O - 431
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2064
Practice Address - Country:US
Practice Address - Phone:949-489-5564
Practice Address - Fax:949-493-9350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health