INNOVATIVE INTEGRATED HEALTH INC (NPI# 1326668823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326668823 |
Entity Type | Organization |
Organization Name | INNOVATIVE INTEGRATED HEALTH INC |
Practice Address |
2042 Kern St Fresno CA 93721-2008 |
Mailing Address |
1200 Newport Center Dr Ste 230 Newport Beach CA 92660-0933 |
Practice Telephone | 9492285577 |
Mailing Telephone | 9492285577 |
Enumeration Date | 2020-04-24 |
Last Update Date | 2020-04-24 |
Authorized Official Name | MR. IBRAHIM MAROUF (CEO) |
Authorized Official Telephone | 9492285577 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251T00000X | PACE Provider Organization | Agencies |
Other Name | Type Code |
---|---|
Fresno PACE, Bakersfield PACE | Doing Business As Name - Organization |
Street Address |
2042 KERN ST |
City | FRESNO |
State | CA |
Zip Code | 93721-2008 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518247345 | Cynthia Kay Cortes | Counselor | 2042 Kern St, Fresno, CA 93721-2008 | 2011-08-24 |
1669088258 | Chong Mandy Heu | Registered Nurse | 2042 Kern St, Fresno, CA 93721-2008 | 2020-09-18 |
1457994881 | Adrian Rodriguez | Nurse Practitioner | 2042 Kern St, Fresno, CA 93721-2008 | 2019-10-17 |
1265082150 | Linda Mee Yang | Nurse Practitioner | 2042 Kern St, Fresno, CA 93721-2008 | 2019-09-12 |
1669928644 | Julio Alonso Garibay | Nurse Practitioner | 2042 Kern St, Fresno, CA 93721-2008 | 2016-08-29 |
1578951679 | Lily Mendoza | Social Worker | 2042 Kern St, Fresno, CA 93721-2008 | 2014-12-26 |
1518355684 | Chour Thao | Registered Nurse | 2042 Kern St, Fresno, CA 93721-2008 | 2014-12-24 |
1043608110 | Elvira Milan | Physical Therapist | 2042 Kern St, Fresno, CA 93721-2008 | 2014-12-24 |
1639567704 | Jaime William | Recreation Therapist | 2042 Kern St, Fresno, CA 93721-2008 | 2014-12-24 |
1619365780 | Meliton V. Pallares Jr. | Registered Nurse | 2042 Kern St, Fresno, CA 93721-2008 | 2014-12-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487297107 | Fareeha Sipra | Nurse Practitioner | Fresno County Jail, 1225 M Street, Fresno, CA 93721 | 2019-10-25 |
1619521929 | Kepler Education Incorporation | Local Education Agency (LEA) | 1462 Broadway St., Fresno, CA 93721 | 2019-07-25 |
1588156434 | Micha Ramirez | Case Manager/Care Coordinator | 2140 Merced St., Fresno, CA 93721 | 2018-06-05 |
1649798992 | Nadia C Martinez | Licensed Vocational Nurse | 1310 M. Street, Fresno, CA 93721 | 2017-09-07 |
1538604251 | Be Together Home Care LLC | In Home Supportive Care | 2014 Tulare St Ste 605, Fresno, CA 93721 | 2017-01-04 |
1124426705 | Central California Faculty Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2554 Merced Street, Fresno, CA 93721 | 2014-12-12 |
1427455336 | University Medical Supply | Durable Medical Equipment & Medical Supplies | 2554 Merced St, Fresno, CA 93721 | 2014-11-21 |
1154723542 | Ryan Gil | Physical Therapist | 1350 O St Ste 201, Fresno, CA 93721 | 2014-09-17 |
1831526250 | Tiffany Marie Gonzalez | Counselor | 2409 Mered St #106, Fresno, CA 93721 | 2013-09-30 |
1972939783 | Reshale L Thomas | Psychologist | 2900 Fresno St Ste 108, Fresno, CA 93721 | 2013-09-25 |
Find all providers in zip 93721 |
Taxonomy Code | 251T00000X |
Grouping | Agencies |
Classification | PACE Provider Organization |
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063988384 | Sequoia Pace, LLC. | PACE Provider Organization | 1649 Van Ness Ave, Fresno, CA 93721-1128 | 2018-10-15 |
1134777071 | California Impact Services | PACE Provider Organization | 1616 W Shaw Ave Ste B4, Fresno, CA 93711-3513 | 2019-09-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871191932 | One Family Health Enterprise | PACE Provider Organization | 206 E 185th St, Carson, CA 90746-1706 | 2020-10-12 |
1003445073 | North East Medical Services | PACE Provider Organization | 728 Pacific Ave Ste 201, San Francisco, CA 94133-4449 | 2020-04-02 |
1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
1669037362 | Medrev | PACE Provider Organization | 558 Chelsea Way, Corona, CA 92879-5880 | 2019-05-08 |
1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
1457838955 | La Coast Pace, LLC | PACE Provider Organization | 1220 E 4th St, Long Beach, CA 90802-1831 | 2018-07-26 |
1194202697 | Pacific Pace, LLC | PACE Provider Organization | 50 Alessandro Pl Ste A20, Pasadena, CA 91105-3149 | 2018-07-26 |
1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
1063901767 | Humboldt Mobile Massage, Inc | PACE Provider Organization | 1737 Margaret Ln, Arcata, CA 95521-6838 | 2018-05-08 |
1669986410 | Vast Oceanside Elderly Care | PACE Provider Organization | 452 Foussat Rd, Oceanside, CA 92054-4709 | 2017-11-30 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.