Provider Demographics
NPI:1841602570
Name:INTEGRA SERVICECONNECT LLC
Entity Type:Organization
Organization Name:INTEGRA SERVICECONNECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YUHAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-581-3030
Mailing Address - Street 1:10065 RED RUN BLVD.
Mailing Address - Street 2:SUITE 230
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:410-581-3030
Mailing Address - Fax:410-581-2018
Practice Address - Street 1:10065 RED RUN BLVD.
Practice Address - Street 2:SUITE 230
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117
Practice Address - Country:US
Practice Address - Phone:410-581-3030
Practice Address - Fax:410-581-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care