Provider Demographics
NPI:1427598291
Name:INTEGRITY RESOURCES HOMECARE LLC
Entity Type:Organization
Organization Name:INTEGRITY RESOURCES HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAVONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-272-2496
Mailing Address - Street 1:176 PALMETTO PARK CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7017
Mailing Address - Country:US
Mailing Address - Phone:803-351-8171
Mailing Address - Fax:
Practice Address - Street 1:3031 SCOTSMAN RD STE 21-22
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-1812
Practice Address - Country:US
Practice Address - Phone:803-351-8171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0684253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care