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General NPI Number Information
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NPI Number | 1215468798
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Entity Type | Organization
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Legal Business Name | INTEGRACARE INC
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Dates
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Enumeration Date | 03/25/2017
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 2920 HARRISON AVE NW SUITE B
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City | OLYMPIA
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State | WA
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Zip | 98502-2604
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Country | US
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Telephone | 360-338-0837
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Fax | 360-705-9052
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Provider Business Mailing Address
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Address Line | 2920 HARRISON AVE NW SUITE B
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City | OLYMPIA
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State | WA
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Zip | 98502-2604
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Country | US
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Telephone | 360-338-0837
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Fax | 360-705-9052
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Authorized Official
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Title or Position | GENERAL MANAGER & OWNER
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Name | MR. BRADLEY F ROSSMAN
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Credential |
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Telephone | 360-338-0837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IHS.FS.60384083
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | IHS.FS.60384083
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | IHS.FS.60384083
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | IHS.FS.60384083
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License Number State | WA
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