Provider Demographics
NPI:1215121702
Name:INTEGRITY HEALTH CARE SERVICES LLC
Entity type:Organization
Organization Name:INTEGRITY HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADIMISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ENID
Authorized Official - Middle Name:
Authorized Official - Last Name:MUMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-245-3643
Mailing Address - Street 1:1013 111TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-4519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1013 111TH AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-4519
Practice Address - Country:US
Practice Address - Phone:763-245-3642
Practice Address - Fax:763-862-7438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN337591251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health