Provider Demographics
NPI:1679155121
Name:INTEGRATIVE HEALTH CARE, LLC
Entity type:Organization
Organization Name:INTEGRATIVE HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:NARCISSE
Authorized Official - Last Name:BREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:337-484-3216
Mailing Address - Street 1:406 VALLEY VW
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-1281
Mailing Address - Country:US
Mailing Address - Phone:337-967-3016
Mailing Address - Fax:
Practice Address - Street 1:913 S COLLEGE RD STE 101
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3061
Practice Address - Country:US
Practice Address - Phone:337-967-3016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-24
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center