Provider Demographics
NPI:1922372697
Name:INTEGRATED FAMILY SERVICES, PLLC
Entity Type:Organization
Organization Name:INTEGRATED FAMILY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:MANLEY-ROOK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:252-439-0700
Mailing Address - Street 1:PO BOX 885
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-0885
Mailing Address - Country:US
Mailing Address - Phone:252-862-4411
Mailing Address - Fax:252-862-4414
Practice Address - Street 1:9486 NC HWY 305
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NC
Practice Address - Zip Code:27845-9679
Practice Address - Country:US
Practice Address - Phone:252-534-1088
Practice Address - Fax:252-534-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty