Provider Demographics
NPI:1053603167
Name:INTEGRATIONS WELLNESS & RECOVERY CENTER, LLC
Entity type:Organization
Organization Name:INTEGRATIONS WELLNESS & RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO, TREATMENT DIRECT, MS, LPCC
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPCC
Authorized Official - Phone:320-434-1312
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-0683
Mailing Address - Country:US
Mailing Address - Phone:320-434-1312
Mailing Address - Fax:651-925-0087
Practice Address - Street 1:1135 HIGHWAY 7 W
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-1511
Practice Address - Country:US
Practice Address - Phone:320-434-1312
Practice Address - Fax:651-925-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-08
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder