Provider Demographics
NPI:1699538736
Name:INTEGRA HOME CARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:INTEGRA HOME CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELISME
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-363-2114
Mailing Address - Street 1:6520 US HIGHWAY 301 S STE 104
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4324
Mailing Address - Country:US
Mailing Address - Phone:813-776-1671
Mailing Address - Fax:813-400-1084
Practice Address - Street 1:6520 US HIGHWAY 301 S STE 104
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4324
Practice Address - Country:US
Practice Address - Phone:813-776-1671
Practice Address - Fax:813-400-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care