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General NPI Number Information
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NPI Number | 1710648274
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Entity Type | Organization
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Legal Business Name | INTEGRATED SUPPORT & FACILITATION, LLC
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 8112 WOODINGTON CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46259-5765
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Country | US
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Telephone | 219-776-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 8112 WOODINGTON CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46259-5765
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Country | US
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Telephone | 219-776-1003
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Fax |
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Authorized Official
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Title or Position | MANAGING OWNER
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Name | MRS. MARLA HOOVER
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Credential |
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Telephone | 317-440-5779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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