Provider Demographics
NPI:1295368363
Name:INTEGRITY ADULT CARE HOME
Entity Type:Organization
Organization Name:INTEGRITY ADULT CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMODEAN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:602-716-1189
Mailing Address - Street 1:20493 N 91ST DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-5271
Mailing Address - Country:US
Mailing Address - Phone:602-716-1189
Mailing Address - Fax:888-855-5677
Practice Address - Street 1:20493 N 91ST DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-5271
Practice Address - Country:US
Practice Address - Phone:602-716-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility