Healthcare Provider Details

I. General information

NPI: 1538838925
Provider Name (Legal Business Name): INTEGRATIVE MINDS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 MAIN ST
LA PORTE CITY IA
50651-1235
US

IV. Provider business mailing address

3004 CYPRESS AVE
CEDAR FALLS IA
50613-1105
US

V. Phone/Fax

Practice location:
  • Phone: 319-505-5602
  • Fax: 319-575-6100
Mailing address:
  • Phone: 563-542-2402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIAH FURY-SWISHER
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: ARNP
Phone: 319-505-5602