Intensive Out-Patient Care

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

371259842 Issued in IL

Legal business name

INTENSIVE OUT-PATIENT CARE

Practice address

2 Club Centre CT
Suite 1
Edwardsville, IL 62025-3503

Phone

(618) 656-7064

Fax

(618) 656-9084

NPI assigned

Jul 20, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Jennifer Mary Manning, LCSW

Title

Director

Phone

(618) 656-7064

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Montana Sky Brown, L.C.P.C.

  • Professional Counselor
  • Edwardsville, IL
  • NPI 1023208535
  NPD (past)

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1255715280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CLUB CENTRE CT",
            "address_2": "SUITE 1",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253503",
            "telephone_number": "618-656-7064",
            "fax_number": "618-656-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CLUB CENTRE CT",
            "address_2": "SUITE 1",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253503",
            "telephone_number": "618-656-7064",
            "fax_number": "618-656-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENSIVE OUT-PATIENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "618-656-7064",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "371259842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Medical Group LTD
• Integrated Medical Group LTD
• Integrated Medical Group, LTD
• Integrative Performance Medical Group, PLLC
• Integrity Nurse Staffing
• Intensive Out-Patient Care
• Interfaith Counseling Center
• Malina Lynn Isaak
• Gabrielle Andrea Ivy, RBT
• Lauren Mae Iwakiri

• Community/Behavioral Health Agency in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.