NPIMap

Organization Active NPI

Integro Health Systems, Inc.

Doing business as Integro Behavioral Facility

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1972079747
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INTEGRO HEALTH SYSTEMS, INC.
Doing business as
Integro Behavioral Facility
Practice address
1501 E Orangewood Ave BLDG C
Phoenix, AZ 85020-5130
Phone
(602) 535-8200
Fax
(602) 457-2517
NPI assigned
Oct 19, 2018
Last updated
Dec 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Authorized official

Name
Dr. Marco Valerio Canulla, MD
Title
Founder and Chairman
Phone
(602) 571-6521

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Psychiatric Hospital 283Q00000X

Addresses

Primary practice location

1501 E Orangewood Ave BLDG C
Phoenix, AZ 85020-5130

Mailing address

1501 E Orangewood Ave
Phoenix, AZ 85020-5130
Phone (602) 535-8200

Other names 1

  • Integro Behavioral Facility Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545955200000",
    "number": "1972079747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E ORANGEWOOD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205130",
            "telephone_number": "602-535-8200",
            "fax_number": "602-457-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E ORANGEWOOD AVE BLDG C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205130",
            "telephone_number": "602-535-8200",
            "fax_number": "602-457-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRO HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-12-28",
        "status": "A",
        "authorized_official_last_name": "CANULLA",
        "authorized_official_first_name": "MARCO",
        "authorized_official_middle_name": "VALERIO",
        "authorized_official_title_or_position": "FOUNDER AND CHAIRMAN",
        "authorized_official_telephone_number": "602-571-6521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integro Behavioral Facility",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Integro Behavioral Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.