Provider Demographics
NPI:1871545962
Name:INTEGRICARE, INC.
Entity type:Organization
Organization Name:INTEGRICARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:C
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-741-6565
Mailing Address - Street 1:2070 S SILVERSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-8108
Mailing Address - Country:US
Mailing Address - Phone:208-321-0866
Mailing Address - Fax:208-321-0860
Practice Address - Street 1:2070 S SILVERSTONE WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-8108
Practice Address - Country:US
Practice Address - Phone:208-321-0866
Practice Address - Fax:208-321-0860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDHH-193251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
137006Medicare ID - Type UnspecifiedMEDICARE