Provider Demographics
NPI:1508057357
Name:INTEGRICARE INC
Entity Type:Organization
Organization Name:INTEGRICARE INC
Other - Org Name:EXTEND-A-CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-253-2273
Mailing Address - Street 1:145 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2607
Mailing Address - Country:US
Mailing Address - Phone:304-253-2273
Mailing Address - Fax:304-253-3930
Practice Address - Street 1:145 GEORGE ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2607
Practice Address - Country:US
Practice Address - Phone:304-253-2273
Practice Address - Fax:304-253-3930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based