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General NPI Number Information
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NPI Number | 1295500577
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Entity Type | Organization
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Legal Business Name | INTEGRICARE LLC
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 1888 HOLLYWOOD RD NW UNIT 7401
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City | ATLANTA
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State | GA
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Zip | 30318-3206
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Country | US
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Telephone | 678-575-9304
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20012
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City | ATLANTA
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State | GA
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Zip | 30325-0012
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Country | US
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Telephone | 678-575-9304
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER MELTON
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Credential |
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Telephone | 678-575-9304
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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 |
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License Number State |
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