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General NPI Number Information
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NPI Number | 1699381269
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PSYCHIATRIC CARE PLLC
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Dates
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Enumeration Date | 09/19/2020
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 2800 SAINT LEO ST
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City | GREENSBORO
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State | NC
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Zip | 27405-3382
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Country | US
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Telephone | 336-676-4060
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Fax | 336-676-5017
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Provider Business Mailing Address
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Address Line | 2800 SAINT LEO ST
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City | GREENSBORO
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State | NC
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Zip | 27405-3382
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Country | US
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Telephone | 336-676-4060
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Fax | 336-676-5017
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Authorized Official
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Title or Position | CLINICAL ADMINISTRATIVE MANAGER
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Name | SAMANTHA EDEH
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Credential |
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Telephone | 336-676-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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