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General NPI Number Information
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NPI Number | 1306176748
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Entity Type | Organization
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Legal Business Name | INTEGRAL REHABILITATION, LLC
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Dates
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Enumeration Date | 01/07/2010
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 6771 S 900 E
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City | MIDVALE
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State | UT
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Zip | 84047-1436
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Country | US
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Telephone | 801-696-5257
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Fax | 801-683-1589
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Provider Business Mailing Address
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Address Line | 49 E 96TH ST
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City | NEW YORK
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State | NY
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Zip | 10128-0782
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Country | US
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Telephone | 801-696-5257
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Fax | 801-831-5896
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Authorized Official
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Title or Position | CEO
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Name | DR. HALLIE J ROBBINS
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Credential | DO
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Telephone | 801-696-5257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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