Provider Demographics
NPI:1073989018
Name:INTERGRITY CONSUMER DIRECTED SERVICES
Entity Type:Organization
Organization Name:INTERGRITY CONSUMER DIRECTED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ERNESTINE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-488-0759
Mailing Address - Street 1:8604 BETTY LEE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-4515
Mailing Address - Country:US
Mailing Address - Phone:314-488-0759
Mailing Address - Fax:
Practice Address - Street 1:8604 BETTY LEE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-4515
Practice Address - Country:US
Practice Address - Phone:314-488-0759
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC001419047251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health