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Organization

INTEGRALIFE HEALTH & TRAUMA INSTITUTE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BLESSING A. OKORO RELLIAS PH.D. (PRESIDENT & CEO)
(951) 221-3460
Entity
Organization

Contact information

Practice address
12730 HEACOCK ST, SUITE 7, MORENO VALLEY, CA 92553-3070
(951) 221-3460
(951) 924-0250
Mailing address
12730 HEACOCK ST, SUITE 7, MORENO VALLEY, CA 92553-3070
(951) 221-3460
(951) 924-0250

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
251S00000X
Community/Behavioral Health Agency
Primary
252Y00000X
Early Intervention Provider Agency

Other

Enumeration date
04/28/2015
Last updated
04/28/2015
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