Integrated Interventions LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INTEGRATED INTERVENTIONS LLC

Practice address

2482 E. Glacier Rd.
Hayden Lake, ID 83835

Phone

(208) 651-0095

NPI assigned

Sep 23, 2013

Last updated

Sep 23, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terry Lee Edelmann

Title

Owner

Phone

(208) 651-0095

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379894400000",
    "number": "1669808614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2482 E. GLACIER RD.",
            "city": "HAYDEN LAKE",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-651-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2482 E. GLACIER RD.",
            "city": "HAYDEN LAKE",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-651-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED INTERVENTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-23",
        "last_updated": "2013-09-23",
        "status": "A",
        "authorized_official_last_name": "EDELMANN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-651-0095"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; 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.