| Integro Llc | |
|
1200 N West Avenue Suite 300 Jackson MI 49202 | |
| (517) 789-1234 | |
| (517) 784-7040 |
| Full Name | Integro Llc |
|---|---|
| Speciality | Counselor |
| Location | 1200 N West Avenue, Jackson, Michigan |
| Authorized Official Name and Position | Donna M Meadowcroft (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5177891234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integro Llc 1200 N West Avenue Suite 300 Jackson MI 49202 Ph: (517) 789-1234 | Integro Llc 1200 N West Avenue Suite 300 Jackson MI 49202 Ph: (517) 789-1234 |
| NPI Number | 1457413460 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3375506025 |
|---|---|
| Medicare Enrollment ID | O20170125001987 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457413460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Joanne E Nemecek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902151053 PECOS PAC ID: 3577840685 Enrollment ID: I20170427000974 |
| Provider Name | Nathan Horton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184288433 PECOS PAC ID: 7214349729 Enrollment ID: I20201207001663 |
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