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NPI Code Detail

MEDICARE: INTEGRATED FAMILY SERVICES, PLLC

MEDICARE: INTEGRATED FAMILY SERVICES, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyC003507NC

General Provider Information

NPI Number : 1720221559
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED FAMILY SERVICES, PLLC
Provider Business Mailing Address
First Line : PO BOX 885
Second Line :
City : AHOSKIE
State : NC
Zip : 27910-0885
Country : US
Telephone Number : 252-862-4411
Fax Number : 252-862-4414
Provider Business Practice Location Address
First Line : 1308 HIGHLAND DR
Second Line :
City : WASHINGTON
State : NC
Zip : 27889-3424
Country : US
Telephone Number : 252-946-3690
Fax Number : 252-946-2452
Authorized Official
Title or Position : ADMINISTRATIVE DIRECTOR
Name : MR. ANTHONY JEROME MANLEY-ROOK
Credential : LCSW
Telephone Number : 252-862-4411
Provider Enumeration Date : 04/09/2009
Last Update Date : 04/09/2009

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Directions to “INTEGRATED FAMILY SERVICES, PLLC ” Practice Location

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