Provider Demographics
NPI:1376268177
Name:INTEGRITY LONG TERM CARE LLC
Entity Type:Organization
Organization Name:INTEGRITY LONG TERM CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-490-4325
Mailing Address - Street 1:808 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-7104
Mailing Address - Country:US
Mailing Address - Phone:912-490-4325
Mailing Address - Fax:912-490-2873
Practice Address - Street 1:1600 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-7028
Practice Address - Country:US
Practice Address - Phone:912-490-4325
Practice Address - Fax:912-490-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty