# INTEGRATED HEALTH AND RECOVERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033894050
- **Authorized official:** BETHANIE WILLIAMS FNP-C (NURSE PRACTITIONER)
- **Authorized official phone:** (832) 574-7035

## Contact information

- **Practice address:** 6344 E BROADWAY RD, MESA, AZ 85206-1634
- **Practice address phone:** (832) 210-4868
- **Mailing address:** 11201 N TATUM BLVD STE 300, PHOENIX, AZ 85028-6039
- **Mailing address phone:** (602) 730-2209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/19/2023
- **Last updated:** 06/19/2023