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General NPI Number Information
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NPI Number | 1396467635
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE HEALTH CARE SERVICES OF INDIANA
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Dates
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Enumeration Date | 09/14/2022
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1548 DORSET DR
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City | AVON
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State | IN
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Zip | 46123-5321
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Country | US
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Telephone | 317-480-0421
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Fax |
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Provider Business Mailing Address
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Address Line | 1548 DORSET DR
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City | AVON
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State | IN
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Zip | 46123-5321
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Country | US
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Telephone | 317-480-0421
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | CRYSTAL MCAVOY
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Credential | LPN, CCM
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Telephone | 317-480-0421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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