1972715456 NPI number — INTEGRITY SOCIAL WORK SERVICES LLC

Table of content: (NPI 1972715456)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972715456 NPI number — INTEGRITY SOCIAL WORK SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTEGRITY SOCIAL WORK SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
INTEGRITY SENIOR SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972715456
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 141065
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STATEN ISLAND
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10314-1065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-277-4680
Provider Business Mailing Address Fax Number:
888-556-9797

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2381 HYLAN BLVD STE 13
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10306-3145
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-494-2858
Provider Business Practice Location Address Fax Number:
718-494-5749
Provider Enumeration Date:
05/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DUFF
Authorized Official First Name:
CLAUDETTE
Authorized Official Middle Name:
VIVIENE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
718-494-2858

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  071171 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03982583 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com