Provider Demographics
NPI:1699594770
Name:INTEGRA HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:INTEGRA HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERIFF
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEI-TUTU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-594-9595
Mailing Address - Street 1:1889 MELINDA LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-4894
Mailing Address - Country:US
Mailing Address - Phone:469-594-9595
Mailing Address - Fax:
Practice Address - Street 1:1889 MELINDA LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-4894
Practice Address - Country:US
Practice Address - Phone:469-594-9595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care