# INTEGRAL WELLNESS BOUTIQUE LLC

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

## Provider details

- **NPI number:** 1699644336
- **Authorized official:** ANN DEVINE (MANAGER)
- **Authorized official phone:** (818) 308-0184

## Contact information

- **Practice address:** 15685 HAWTHORNE BLVD STE H, LAWNDALE, CA 90260-3912
- **Practice address phone:** (818) 308-0184
- **Mailing address:** 28201 FRANKLIN PKWY UNIT 27, SANTA CLARITA, CA 91310-7002
- **Mailing address phone:** (818) 308-0184

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 10/31/2025
- **Last updated:** 10/31/2025