Healthcare Provider Details

I. General information

NPI: 1114822178
Provider Name (Legal Business Name): INTEGRITY RECOVERY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 WILSHIRE BLVD # 867
BEVERLY HILLS CA
90211-2425
US

IV. Provider business mailing address

8383 WILSHIRE BLVD # 867
BEVERLY HILLS CA
90211-2425
US

V. Phone/Fax

Practice location:
  • Phone: 310-531-6949
  • Fax:
Mailing address:
  • Phone: 310-531-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: IVANA STANISAVLJEVIC
Title or Position: CEO
Credential:
Phone: 310-531-6949