Provider Demographics
NPI:1245605351
Name:INTEGRITY HOME CARE, LLC.
Entity Type:Organization
Organization Name:INTEGRITY HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:SOUTHIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:XAYACHACK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:414-581-9162
Mailing Address - Street 1:6450 W FOREST HOME AVE
Mailing Address - Street 2:UNIT 102
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-2402
Mailing Address - Country:US
Mailing Address - Phone:414-581-9162
Mailing Address - Fax:414-210-5530
Practice Address - Street 1:6450 W FOREST HOME AVE
Practice Address - Street 2:UNIT 102
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-2402
Practice Address - Country:US
Practice Address - Phone:414-581-9162
Practice Address - Fax:414-210-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health