Provider Demographics
NPI:1558018648
Name:INTEGRATED FUNCTIONAL SUPPORTS, LLC
Entity Type:Organization
Organization Name:INTEGRATED FUNCTIONAL SUPPORTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDSAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, LBA
Authorized Official - Phone:517-462-1566
Mailing Address - Street 1:102 PILLSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1564
Mailing Address - Country:US
Mailing Address - Phone:517-462-1566
Mailing Address - Fax:
Practice Address - Street 1:235 E. CHICAGO RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-4903
Practice Address - Country:US
Practice Address - Phone:517-462-1566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No385H00000XRespite Care FacilityRespite Care