Provider Demographics
NPI:1699319947
Name:INTEGRATED COMMUNITY SERVICES, INC.
Entity type:Organization
Organization Name:INTEGRATED COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:OMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-434-3503
Mailing Address - Street 1:6323 GEORGIA AVE NW STE 350
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1151
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6323 GEORGIA AVE NW STE 350
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1151
Practice Address - Country:US
Practice Address - Phone:202-878-6993
Practice Address - Fax:202-878-6978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health