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General NPI Number Information
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NPI Number | 1891760328
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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 | 02/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 500 SE CASS AVE SUITE 260
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City | ROSEBURG
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State | OR
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Zip | 97470-3103
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Country | US
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Telephone | 541-440-2583
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Fax | 541-440-2530
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Provider Business Mailing Address
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Address Line | 9 S CHERRY ST
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City | WALLINGFORD
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State | CT
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Zip | 06492-3537
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Country | US
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Telephone | 203-741-6464
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Fax | 203-269-2227
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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 | 203-741-6464
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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 | 13-1368
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License Number State | OR
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