Healthcare Provider Details

I. General information

NPI: 1841812021
Provider Name (Legal Business Name): INTEGRATED HEALTHCARE SYSTEMS RIVIERA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N SAPODILLA AVE STE 3
WEST PALM BEACH FL
33401-3640
US

IV. Provider business mailing address

800 N SAPODILLA AVE STE 3
WEST PALM BEACH FL
33401-3640
US

V. Phone/Fax

Practice location:
  • Phone: 561-510-0471
  • Fax: 561-331-2715
Mailing address:
  • Phone: 561-510-0471
  • Fax: 561-331-2715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE D BROWN FAUST
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 561-899-9140