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NPI 1871545962

NPI 1871545962 : INTEGRICARE, INC. : MERIDIAN, ID

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General NPI Number Information
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    NPI Number           |    1871545962
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    Entity Type          |    Organization 
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    Legal Business Name  |    INTEGRICARE, INC. 
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Dates
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    Enumeration Date     |    05/17/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    2070 S SILVERSTONE WAY 
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    City                 |    MERIDIAN
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    State                |    ID
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    Zip                  |    83642-8108
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    Country              |    US
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    Telephone            |    208-321-0866
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    Fax                  |    208-321-0860
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Provider Business Mailing Address
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    Address Line         |    2070 S SILVERSTONE WAY 
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    City                 |    MERIDIAN
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    State                |    ID
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    Zip                  |    83642-8108
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    Country              |    US
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    Telephone            |    208-321-0866
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    Fax                  |    208-321-0860
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Authorized Official
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    Title or Position    |    VICE PRESIDENT/CFO
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    Name                 |     JON C ESTES 
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    Credential           |    
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    Telephone            |    203-741-6565
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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       |    HH-193
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    License Number State |    ID
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