Provider Demographics
NPI:1124633565
Name:CENTER FOR INTEGRATIVE HEALTH
Entity type:Organization
Organization Name:CENTER FOR INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLIE
Authorized Official - Middle Name:ELISABETH
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-812-2232
Mailing Address - Street 1:231 LOWELL ST # 1
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-5020
Mailing Address - Country:US
Mailing Address - Phone:617-812-2232
Mailing Address - Fax:
Practice Address - Street 1:231 LOWELL ST # 1
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-5020
Practice Address - Country:US
Practice Address - Phone:617-812-2232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-12
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty