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General NPI Number Information
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NPI Number | 1770020190
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Entity Type | Organization
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Legal Business Name | INTEQ ALLIANCE, INC.
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 01/23/2017
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Provider Practice Location Address
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Address Line | 1737 PINEKNOLL LN
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City | ALBANY
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State | GA
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Zip | 31707-3778
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Country | US
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Telephone | 229-603-1968
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Fax | 229-432-0671
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Provider Business Mailing Address
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Address Line | 1737 PINEKNOLL LN
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City | ALBANY
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State | GA
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Zip | 31707-3778
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Country | US
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Telephone | 229-603-1968
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Fax | 229-432-0671
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Authorized Official
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Title or Position | DIRECTOR
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Name | SAMANTHA ELAINE AKINNUBI
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Credential |
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Telephone | 229-603-1968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | AB16-000628
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License Number State | GA
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