Healthcare Provider Details

I. General information

NPI: 1255093381
Provider Name (Legal Business Name): INTEGRATED HEALTHCARE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8828 RAY CT APT 7
TWINSBURG OH
44087-2075
US

IV. Provider business mailing address

8828 RAY CT APT 7
TWINSBURG OH
44087-2075
US

V. Phone/Fax

Practice location:
  • Phone: 216-924-6101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGEL SMITH
Title or Position: LPN
Credential:
Phone: 216-942-6101