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General NPI Number Information
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NPI Number | 1649520412
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Entity Type | Organization
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Legal Business Name | INTERGRATED HEALTH SOLUTIONS, INC.,
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 04/14/2014
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Provider Practice Location Address
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Address Line | 1601B E 20TH ST
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City | FARMINGTON
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State | NM
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Zip | 87401-4307
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Country | US
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Telephone | 505-990-2245
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Fax | 505-792-6602
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Provider Business Mailing Address
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Address Line | 204 W MAIN ST
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City | FARMINGTON
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State | NM
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Zip | 87401-6245
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Country | US
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Telephone | 505-990-2245
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Fax | 505-792-6602
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Authorized Official
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Title or Position | CEO
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Name | MR. RALFORD GREGORY KING-HUTCHINS
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Credential |
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Telephone | 505-516-0448
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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 | 2T3368
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License Number State | NM
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