Provider Demographics
NPI:1194186585
Name:STONERISE INTEGRITY CARE LLC
Entity Type:Organization
Organization Name:STONERISE INTEGRITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-343-1950
Mailing Address - Street 1:700 CHAPPELL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2704
Mailing Address - Country:US
Mailing Address - Phone:304-343-1950
Mailing Address - Fax:304-343-1947
Practice Address - Street 1:700 CHAPPELL RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2704
Practice Address - Country:US
Practice Address - Phone:304-343-1950
Practice Address - Fax:304-343-1947
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STONERISE AT HOME HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-11
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care