Provider Demographics
NPI:1922582501
Name:INTEGRITY PSYCHIATRIC SERVICES, LLC
Entity Type:Organization
Organization Name:INTEGRITY PSYCHIATRIC SERVICES, LLC
Other - Org Name:INTEGRITY MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:CRILL
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:208-283-7314
Mailing Address - Street 1:5440 W FRANKLIN RD STE 108
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-6433
Mailing Address - Country:US
Mailing Address - Phone:208-283-7314
Mailing Address - Fax:
Practice Address - Street 1:5440 W FRANKLIN RD STE 108
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-6433
Practice Address - Country:US
Practice Address - Phone:208-283-7714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health