MEDICARE: INTEGRATION AND HEALING CENTER INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1346754223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATION AND HEALING CENTER INC.

Provider Business Mailing Address
First Line	:	5610 SE 2ND ST
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34480-3530
Country	:	US
Telephone Number	:	352-304-0933
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 N MAGNOLIA AVE STE 216
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34475-6643
Country	:	US
Telephone Number	:	352-304-0933
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	MRS. CHENORA NETASCHIA ADJEI-CHRISTIE
Credential	:	MSW
Telephone Number	:	352-304-0933

Provider Enumeration Date	:	11/30/2017
Last Update Date	:	11/30/2017

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