Healthcare Provider Details

I. General information

NPI: 1619506128
Provider Name (Legal Business Name): INTEGRO HEALTH SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E ORANGEWOOD AVE UNIT B
PHOENIX AZ
85020-5130
US

IV. Provider business mailing address

1501 E ORANGEWOOD AVE
PHOENIX AZ
85020-5130
US

V. Phone/Fax

Practice location:
  • Phone: 602-535-8200
  • Fax: 602-457-2516
Mailing address:
  • Phone: 602-535-8200
  • Fax: 602-283-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: DENISE DAIN
Title or Position: COO
Credential:
Phone: 602-457-2505