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General NPI Number Information
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NPI Number | 1699594770
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Entity Type | Organization
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Legal Business Name | INTEGRA HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1889 MELINDA LN
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City | DALLAS
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State | TX
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Zip | 75234-4894
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Country | US
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Telephone | 469-594-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 1889 MELINDA LN
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City | DALLAS
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State | TX
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Zip | 75234-4894
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Country | US
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Telephone | 469-594-9595
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHERIFF OSEI-TUTU
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Credential | RN
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Telephone | 469-594-9595
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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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