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General NPI Number Information
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NPI Number | 1134466303
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Entity Type | Organization
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Legal Business Name | THE INTEGRITY NETWORK MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 01/08/2013
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 812 SCENIC CREEK DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7802
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Country | US
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Telephone | 770-256-4019
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Fax | 770-685-1145
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Provider Business Mailing Address
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Address Line | 812 SCENIC CREEK DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7802
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Country | US
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Telephone | 770-256-4019
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Fax | 770-685-1145
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MS. DELORES SEARSS
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Credential | LICENSE NURSE
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Telephone | 770-256-4019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | LPN35200
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | LPN35200
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | LPN35200
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License Number State | GA
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