Provider Demographics
NPI:1134766686
Name:INTEGRITY FAMILY SERVICE CORP
Entity type:Organization
Organization Name:INTEGRITY FAMILY SERVICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:O
Authorized Official - Last Name:FATUYI
Authorized Official - Suffix:
Authorized Official - Credentials:DM
Authorized Official - Phone:804-319-9129
Mailing Address - Street 1:9409 SNOWBIRD RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6820
Mailing Address - Country:US
Mailing Address - Phone:804-319-9129
Mailing Address - Fax:
Practice Address - Street 1:9409 SNOWBIRD RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6820
Practice Address - Country:US
Practice Address - Phone:804-319-9129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities