MEDICARE: INTEGRITY MCDOWELL HOUSE, 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	311ZA0620X	Adult Care Home Facility	HAL-059-034	NC

General Provider Information

NPI Number	:	1538689625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY MCDOWELL HOUSE, LLC

Provider Business Mailing Address
First Line	:	4900 KOGER BLVD STE 150
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-2738
Country	:	US
Telephone Number	:	336-438-1383
Fax Number	:

Provider Business Practice Location Address
First Line	:	1687 DAIRY DR
Second Line	:
City	:	NEBO
State	:	NC
Zip	:	28761-6810
Country	:	US
Telephone Number	:	828-584-6811
Fax Number	:

Authorized Official
Title or Position	:	CIO
Name	:	JONATHAN SWAIN SHORT
Credential	:
Telephone Number	:	336-438-1383

Provider Enumeration Date	:	06/21/2017
Last Update Date	:	11/18/2021

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