Provider Demographics
NPI:1053092148
Name:INTEGRATED HEALTHCARE SYSTEMS RIVIERA INC
Entity type:Organization
Organization Name:INTEGRATED HEALTHCARE SYSTEMS RIVIERA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN FAUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-899-9140
Mailing Address - Street 1:31 W 20TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-6155
Mailing Address - Country:US
Mailing Address - Phone:561-899-9140
Mailing Address - Fax:561-331-2715
Practice Address - Street 1:31 W 20TH ST STE 200
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-6155
Practice Address - Country:US
Practice Address - Phone:561-899-9140
Practice Address - Fax:561-331-2715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center