| Organization Name: | INTEGRATED CARE, LLC |
| NPI Number: | 1104154913 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL T UNDERWOOD (AGENT) |
| Mailing Address: | 540 E Hjellen Drive Wasilla |
| State: | AK US |
| Postal Code: | 99654 |
| Phone Number: | 9076961654 |
| Fax Number: | 9076963654 |
| NPI Enumeration Date: | 12/07/2009 |
| NPI Last Update Date: | 12/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 380 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |