Healthcare Provider Details

I. General information

NPI: 1669983433
Provider Name (Legal Business Name): INTEGRITY MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N GILBERT RD STE 104
GILBERT AZ
85234-4511
US

IV. Provider business mailing address

625 N GILBERT RD STE 104
GILBERT AZ
85234-4511
US

V. Phone/Fax

Practice location:
  • Phone: 480-834-3507
  • Fax: 480-834-3982
Mailing address:
  • Phone: 480-834-3507
  • Fax: 480-834-3982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number6520
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6193
License Number StateAZ

VIII. Authorized Official

Name: JENNIFER E RAMIREZ
Title or Position: OWNER
Credential: PA
Phone: 480-834-3507