MEDICARE: REINTEGRATIVE HEALTH INSTITUTE, LLC

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	106H00000X	Marriage & Family Therapist	2001014120	MO

General Provider Information

NPI Number	:	1699843110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REINTEGRATIVE HEALTH INSTITUTE, LLC

Provider Business Mailing Address
First Line	:	1610 DES PERES RD
Second Line	:	SUITE 340
City	:	DES PERES
State	:	MO
Zip	:	63131-1813
Country	:	US
Telephone Number	:	314-984-8412
Fax Number	:

Provider Business Practice Location Address
First Line	:	1610 DES PERES RD
Second Line	:	SUITE 340
City	:	DES PERES
State	:	MO
Zip	:	63131-1813
Country	:	US
Telephone Number	:	314-984-8412
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. WILLIAM GEORGE COLLINS
Credential	:	PH.D.
Telephone Number	:	314-984-8412

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	01/25/2008

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