Provider Demographics
NPI:1114248184
Name:INTEGRATED FAMILY SERVICES, PLLC
Entity Type:Organization
Organization Name:INTEGRATED FAMILY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:MANLEY-ROOK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:252-862-4411
Mailing Address - Street 1:PO BOX 885
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-0885
Mailing Address - Country:US
Mailing Address - Phone:252-862-4411
Mailing Address - Fax:252-862-4411
Practice Address - Street 1:411 MAIN ST W
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3321
Practice Address - Country:US
Practice Address - Phone:252-862-4411
Practice Address - Fax:252-862-4414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health