Provider Demographics
NPI:1730916370
Name:INTEGRATED COMMUNITY SERVICES
Entity type:Organization
Organization Name:INTEGRATED COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF LIVING SKILLS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PINKERTON
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:415-275-1108
Mailing Address - Street 1:65 MITCHELL BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2079
Mailing Address - Country:US
Mailing Address - Phone:415-275-1108
Mailing Address - Fax:
Practice Address - Street 1:65 MITCHELL BLVD STE 104
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2079
Practice Address - Country:US
Practice Address - Phone:415-275-1108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management