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General NPI Number Information
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NPI Number | 1699538736
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Entity Type | Organization
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Legal Business Name | INTEGRA HOME CARE SOLUTIONS, LLC
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 6520 US HIGHWAY 301 S STE 104
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City | RIVERVIEW
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State | FL
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Zip | 33578-4324
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Country | US
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Telephone | 813-776-1671
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Fax | 813-400-1084
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Provider Business Mailing Address
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Address Line | 6520 US HIGHWAY 301 S STE 104
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City | RIVERVIEW
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State | FL
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Zip | 33578-4324
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Country | US
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Telephone | 813-776-1671
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Fax | 813-400-1084
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JACQUELINE DELISME
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Credential | RN
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Telephone | 813-363-2114
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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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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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