{
"Npi": {
"NPI": "1073471793",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INTEGRATIVE CARE SOLUTIONS LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "109 ANDERSON ST SE STE 602",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MARIETTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30060-8610",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "678-382-9916",
"MailingAddressFaxNumber": "770-299-3003",
"FirstLinePracticeLocationAddress": "109 ANDERSON ST SE STE 602",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MARIETTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30060-8610",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "678-382-9916",
"PracticeLocationAddressFaxNumber": "770-299-3003",
"EnumerationDate": "01/12/2026",
"LastUpdateDate": "01/12/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCLENDON",
"AuthorizedOfficialFirstName": "LAVERN",
"AuthorizedOfficialMiddleName": "ROSEMARIE",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "678-382-9916",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "252Y00000X",
"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}