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Organization
INTEGRATION MENTAL HEALTH LLC
Active
Organization
INTEGRATION MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN PONDER (OWNER)
(970) 590-1138
Entity
Organization
Contact information
Practice address
1919 65TH AVE STE C, GREELEY, CO 80634-7965
(970) 590-1138
Mailing address
1919 65TH AVE STE C, GREELEY, CO 80634-7965
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
130627
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336496330
NPI-INDIVIDUAL
CO
05
—
15283739
—
CO
Enumeration date
11/11/2015
Last updated
08/02/2023
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