Healthcare Provider Details

I. General information

NPI: 1861861338
Provider Name (Legal Business Name): INTEGRATED SENIOR CARE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 S RIVER RD SUITE 200
SAINT GEORGE UT
84790
US

IV. Provider business mailing address

616 S RIVER RD SUITE 200
SAINT GEORGE UT
84790-2104
US

V. Phone/Fax

Practice location:
  • Phone: 435-628-8944
  • Fax: 435-635-4506
Mailing address:
  • Phone: 435-628-8944
  • Fax: 435-635-4506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA-UT000730
License Number StateUT

VIII. Authorized Official

Name: JOHN W BRAMALL
Title or Position: PRESIDENT / CEO
Credential:
Phone: 435-628-8944