Provider Demographics
NPI:1972720738
Name:INTEGRATED NURSING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:INTEGRATED NURSING ASSOCIATES, LLC
Other - Org Name:TEAM SELECT HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-618-5760
Mailing Address - Street 1:2999 N 44TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7247
Mailing Address - Country:US
Mailing Address - Phone:480-618-5760
Mailing Address - Fax:602-253-5656
Practice Address - Street 1:32 N BEVERWYCK RD
Practice Address - Street 2:SUITE #6
Practice Address - City:LAKE HIAWATHA
Practice Address - State:NJ
Practice Address - Zip Code:07034-2512
Practice Address - Country:US
Practice Address - Phone:973-331-1901
Practice Address - Fax:973-331-1907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0047300251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0709158Medicaid