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General NPI Number Information
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NPI Number | 1629464227
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Entity Type | Organization
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Legal Business Name | INTEGRATED LIVING, INC.
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 43133 SCHOENHERR RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-1955
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Country | US
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Telephone | 586-731-9800
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Fax | 586-731-3861
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Provider Business Mailing Address
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Address Line | 43133 SCHOENHERR RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48313-1955
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Country | US
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Telephone | 586-731-9800
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Fax | 586-731-3861
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. KAREN MARIE HARRIS
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Credential | OTR/L
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Telephone | 586-747-1930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 5201003225
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License Number State | MI
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