Healthcare Provider Details

I. General information

NPI: 1861926214
Provider Name (Legal Business Name): INTEGRATED COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 GEORGIA AVE NW SUITE 106
WASHINGTON DC
20011-1101
US

IV. Provider business mailing address

10230 NEW HAMPSHIRE AVE SUITE 100
SILVER SPRING MD
20903-1400
US

V. Phone/Fax

Practice location:
  • Phone: 202-506-1209
  • Fax: 202-506-1396
Mailing address:
  • Phone: 301-434-3503
  • Fax: 301-434-3583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHCA-0076
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSE OMA
Title or Position: CEO
Credential:
Phone: 301-434-3503