# INTEGRIS AMBULATORY CARE CORP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** INTEGRIS Jim Thorpe Rehabilitation YMCA Healthy Living Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902370687
- **Authorized official:** BRENT DAVIS (VICE PRESIDENT)
- **Authorized official phone:** (405) 949-3774

## Contact information

- **Practice address:** 5520 N INDEPENDENCE AVE, OKLAHOMA CITY, OK 73112-5641
- **Practice address phone:** (405) 945-4500
- **Practice address fax:** (405) 945-4501
- **Mailing address:** 5520 N INDEPENDENCE AVE, OKLAHOMA CITY, OK 73112-5641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/16/2019
- **Last updated:** 01/23/2019