Provider Demographics
NPI:1295371474
Name:INTEGRATED SOURCES LLC
Entity Type:Organization
Organization Name:INTEGRATED SOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALINGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-297-9557
Mailing Address - Street 1:2334 M ST UNIT 3425
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95344-2264
Mailing Address - Country:US
Mailing Address - Phone:415-297-9557
Mailing Address - Fax:888-728-1604
Practice Address - Street 1:1437 SAN SIMEON CT
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-9532
Practice Address - Country:US
Practice Address - Phone:209-626-5089
Practice Address - Fax:888-728-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility