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NPI Code Detail

MEDICARE: INTEGRATED COMMUNITY SERVICES, INC.

MEDICARE: INTEGRATED COMMUNITY SERVICES, INC.
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
1261QD1600XDevelopmental Disabilities Clinic/Center
2385H00000XRespite Care
3251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407244304
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED COMMUNITY SERVICES, INC.
Provider Business Mailing Address
First Line : 6323 GEORGIA AVE NW STE 350
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-1151
Country : US
Telephone Number : 202-506-1209
Fax Number : 301-434-3583
Provider Business Practice Location Address
First Line : 6323 GEORGIA AVE NW STE 350
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-1151
Country : US
Telephone Number : 202-506-1209
Fax Number : 301-434-3583
Authorized Official
Title or Position : CEO
Name : DR. ROSE OMA
Credential : AUD
Telephone Number : 301-434-3503
Provider Enumeration Date : 12/30/2014
Last Update Date : 07/17/2023

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Directions to “INTEGRATED COMMUNITY SERVICES, INC. ” Practice Location

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