Provider Demographics
NPI:1245752989
Name:INTEGRITY HOUSTON HOUSE LLC
Entity Type:Organization
Organization Name:INTEGRITY HOUSTON HOUSE LLC
Other - Org Name:HOUSTON HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:SWAIN
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-438-1383
Mailing Address - Street 1:4900 KOGER BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2738
Mailing Address - Country:US
Mailing Address - Phone:336-438-1383
Mailing Address - Fax:
Practice Address - Street 1:9460 US HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:UNION MILLS
Practice Address - State:NC
Practice Address - Zip Code:28167-7924
Practice Address - Country:US
Practice Address - Phone:828-287-4943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-059-033311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHAL-059-033OtherSTATE OF NC DHHS