Healthcare Provider Details

I. General information

NPI: 1306284856
Provider Name (Legal Business Name): INTEGRATED HEALTH ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HIAWATHA LN
DOVER DE
19904-2401
US

IV. Provider business mailing address

8401 CONNECTICUT AVE STE 1030
CHEVY CHASE MD
20815-5844
US

V. Phone/Fax

Practice location:
  • Phone: 302-724-7902
  • Fax: 855-631-4365
Mailing address:
  • Phone: 301-652-4344
  • Fax: 301-652-4757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MERIANNE ESTACIO
Title or Position: SENIOR MANAGER OF ACCOUNTING
Credential:
Phone: 240-630-5968