Provider Demographics
NPI:1184858771
Name:INTEGRA HEALTHCARE SOLUTION
Entity Type:Organization
Organization Name:INTEGRA HEALTHCARE SOLUTION
Other - Org Name:FIRST CHOICE HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHENICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-971-8743
Mailing Address - Street 1:2215 S SHADOW GROVE LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-2429
Mailing Address - Country:US
Mailing Address - Phone:832-971-8743
Mailing Address - Fax:
Practice Address - Street 1:2215 S SHADOW GROVE LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2429
Practice Address - Country:US
Practice Address - Phone:832-971-8743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health