Integrated Care Clinicians, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

INTEGRATED CARE CLINICIANS, LLC

Practice address

989 University Dr
Pontiac, MI 48342-1885

Phone

(248) 818-1249

NPI assigned

Oct 8, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barbrene MahluliNPI 1336564285

Title

President

Phone

(313) 673-8636

Specialties & licenses 1

Addresses

Other names 1

• Integrated Care Clinicans,LLC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Barbrene Latrese Mahluli, MSN, RN, NP, ANP-BC

  • Addiction (Substance Use Disorder) Registered Nurse
  • Beverly Hills, MI
  • NPI 1336564285
  Medicare reassignment Authorized official
• Janice Rheaume, LMSW, MSW

  • Clinical Social Worker
  • Farmington Hills, MI
  • NPI 1215115076
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1013558386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 UNIVERSITY DR",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421885",
            "telephone_number": "248-818-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 UNIVERSITY DR",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483421885",
            "telephone_number": "248-818-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED CARE CLINICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "MAHLULI",
        "authorized_official_first_name": "BARBRENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-673-8636"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Integratedmat@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "989 University Dr",
            "city": "Pontiac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483421885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Integrated Care Clinicans,LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Andrea Isham, BSN, RN
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• Robert Solomon Issac, NP-C

• Methadone Clinic in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Methadone Clinic in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.