Provider Demographics
NPI:1497728059
Name:INTEGRICARE, INC.
Entity Type:Organization
Organization Name:INTEGRICARE, INC.
Other - Org Name:PORTSMOUTH/DERRY/SALEM HOME HEALTH AND HOSPICE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:C
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-741-6565
Mailing Address - Street 1:9 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3537
Mailing Address - Country:US
Mailing Address - Phone:203-741-6565
Mailing Address - Fax:203-269-2227
Practice Address - Street 1:95 BREWERY LN
Practice Address - Street 2:#11
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4994
Practice Address - Country:US
Practice Address - Phone:603-436-0815
Practice Address - Fax:603-431-5457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02654251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
301507Medicare ID - Type UnspecifiedMEDICARE HOSPICE