Organization
INTEGRATED WELLNESS CENTER LLC
Active
Other names
RT Builders LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RAVIKULASINGHAM THURAISINGAM (ADMINISTRATOR)
(650) 847-8861
Entity
Organization
Contact information
Practice address
2316 W NORTHERN AVE, PHOENIX, AZ 85021-4935
(602) 838-7799
(602) 844-2525
Mailing address
5523 S JOLLY ROGER RD, TEMPE, AZ 85283-2118
(650) 847-8861
(602) 844-2525
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
05/30/2023
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