Provider Demographics
NPI:1063776664
Name:INTEGRATIVE CARE LLC
Entity type:Organization
Organization Name:INTEGRATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPAGNONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-380-0690
Mailing Address - Street 1:163 MADISON AVE
Mailing Address - Street 2:#220-044
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7358
Mailing Address - Country:US
Mailing Address - Phone:908-380-0690
Mailing Address - Fax:
Practice Address - Street 1:163 MADISON AVE
Practice Address - Street 2:#220-044
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7358
Practice Address - Country:US
Practice Address - Phone:908-380-0690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04932600261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care