MEDICARE: INTEGRICARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1295500577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRICARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 20012
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30325-0012
Country	:	US
Telephone Number	:	678-575-9304
Fax Number	:

Provider Business Practice Location Address
First Line	:	1888 HOLLYWOOD RD NW UNIT 7401
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-3206
Country	:	US
Telephone Number	:	678-575-9304
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER MELTON
Credential	:
Telephone Number	:	678-575-9304

Provider Enumeration Date	:	11/16/2023
Last Update Date	:	11/16/2023

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Directions to “INTEGRICARE LLC ” Practice Location

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