Provider Demographics
NPI:1417431305
Name:INTEGRATED SYCAMORE GROUP LLC
Entity Type:Organization
Organization Name:INTEGRATED SYCAMORE GROUP LLC
Other - Org Name:INTEGRATED SYCAMORE GROUP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:UCHEWUAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-335-4098
Mailing Address - Street 1:22101 GRAND CORNER DR APT 10208
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5948
Mailing Address - Country:US
Mailing Address - Phone:832-335-4098
Mailing Address - Fax:
Practice Address - Street 1:8315 SIERRA HILL CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-5147
Practice Address - Country:US
Practice Address - Phone:832-335-4098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility