Healthcare Provider Details

I. General information

NPI: 1255835666
Provider Name (Legal Business Name): INTEGRATIVE HEALTH NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 S LIBERTY ST
POWELL OH
43065-7619
US

IV. Provider business mailing address

7652 SAWMILL RD STE 311
DUBLIN OH
43016-9296
US

V. Phone/Fax

Practice location:
  • Phone: 614-634-2405
  • Fax:
Mailing address:
  • Phone: 614-634-2405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JASON EDWARD FOLEY
Title or Position: OWNER
Credential: LISW
Phone: 614-634-2405