# INTEGRATED HEALTH CARE PROVIDERS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Facial Surgery Center II
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699781294
- **Authorized official:** JEFF GOODE PT, MBA (PRESIDENT)
- **Authorized official phone:** (304) 388-7783

## Contact information

- **Practice address:** 830 PENNSYLVANIA AVE STE 302, CHARLESTON, WV 25302-3390
- **Practice address phone:** (304) 388-2950
- **Practice address fax:** (304) 388-2951
- **Mailing address:** 415 MORRIS ST STE 304, CHARLESTON, WV 25301-1853
- **Mailing address phone:** (304) 388-7782
- **Mailing address fax:** (304) 388-7788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 11/15/2007