Organization
INTEGRATED HEALTH CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODRICK FRAZIER (CEO)
(678) 765-2733
Entity
Organization
Contact information
Practice address
8600 TARA BLVD, SUITE D, JONESBORO, GA 30236
(678) 834-7615
Mailing address
950 SCALES RD STE 403, SUWANEE, GA 30024-4342
(678) 765-2733
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
122300000X
Dentist
—
—
253J00000X
Foster Care Agency
—
—
364SF0001X
Family Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GA
—
GA
Enumeration date
01/13/2016
Last updated
10/05/2022
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