Provider Demographics
NPI:1356894638
Name:INTEGRATED FAMILY SERVICES, PLLC
Entity type:Organization
Organization Name:INTEGRATED FAMILY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. ADMIN. DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
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:252-439-0700
Mailing Address - Fax:252-439-0900
Practice Address - Street 1:3383 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5231
Practice Address - Country:US
Practice Address - Phone:910-939-6475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health