Provider Demographics
NPI:1194510768
Name:INTEGRITY INTEGRATED SERVICES LLC
Entity type:Organization
Organization Name:INTEGRITY INTEGRATED SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:CLARISSA
Authorized Official - Last Name:BOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:BS QP, MBA, MPH, CH
Authorized Official - Phone:704-466-5504
Mailing Address - Street 1:5525 MALLARD LN
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-4133
Mailing Address - Country:US
Mailing Address - Phone:704-466-5504
Mailing Address - Fax:
Practice Address - Street 1:5525 MALLARD LN
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-4133
Practice Address - Country:US
Practice Address - Phone:704-466-5504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility