Provider Demographics
NPI:1508616442
Name:INTEGRATED HEALTH ASSOCIATES LLC
Entity Type:Organization
Organization Name:INTEGRATED HEALTH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ILYAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMIDZAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-580-6027
Mailing Address - Street 1:8020 BRADLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1908
Mailing Address - Country:US
Mailing Address - Phone:301-580-6027
Mailing Address - Fax:
Practice Address - Street 1:8020 BRADLEY BLVD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1908
Practice Address - Country:US
Practice Address - Phone:301-580-6027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDRSA-02118OtherMD RESIDENTIAL SERVICE AGENCY LICENSE