Provider Demographics
NPI:1912248642
Name:INTEGRITY, INC
Entity Type:Organization
Organization Name:INTEGRITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-623-0600
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:103 LINCOLN PARK
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-0510
Mailing Address - Country:US
Mailing Address - Phone:973-623-0600
Mailing Address - Fax:
Practice Address - Street 1:310 MAIN ST STE 3B
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7401
Practice Address - Country:US
Practice Address - Phone:732-926-4278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000631261QR0405X
NJ1000119324500000X
NJ1000036324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0515124Medicaid
NJ0310158Medicaid
NJ7603207OtherWFNJ MEDICAID PROVIDER
NJ7603100OtherWFNJ MEDICAID PROVIDER
NJ0310131Medicaid
NJ0310328OtherWFNJ MEDICAID PROVIDER
NJ0310310OtherWFNJ MEDICAID PROVIDER
NJ7603401OtherWFNJ MEDICAID PROVIDER
NJ0310352OtherWFNJ MEDICAID PROVIDER
NJ0310221Medicaid
NJ0310166Medicaid
NJ0310361OtherWFNJ MEDICAID PROVIDER