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General NPI Number Information
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NPI Number | 1033642137
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Entity Type | Organization
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Legal Business Name | INTEGRATED LIFE CHOICES, INC.
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 13627 POPLAR CIR STE 104
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City | CONROE
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State | TX
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Zip | 77304-2219
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Country | US
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Telephone | 402-742-0311
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Fax |
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Provider Business Mailing Address
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Address Line | 13627 POPLAR CIR STE 104
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City | CONROE
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State | TX
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Zip | 77304-2219
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Country | US
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Telephone | 402-742-0311
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JOSHUA L MIDGETT
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Credential |
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Telephone | 402-742-0311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 59388
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License Number State | NE
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