MEDICARE: INTEGRATION & HEALING CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1891142493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATION & HEALING CENTER

Provider Business Mailing Address
First Line	:	108 N MAGNOLIA AVE STE 215B
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34475-6643
Country	:	US
Telephone Number	:	352-237-1541
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 N MAGNOLIA AVE STE 215B
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34475-6643
Country	:	US
Telephone Number	:	352-237-1541
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LATONYA T OATS
Credential	:	LMHC
Telephone Number	:	352-278-1541

Provider Enumeration Date	:	05/24/2016
Last Update Date	:	05/24/2016

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Directions to “INTEGRATION & HEALING CENTER ” Practice Location

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