Provider Demographics
NPI:1679900641
Name:INTEGRATED HEALTHCARE SOLUTIONS INC
Entity type:Organization
Organization Name:INTEGRATED HEALTHCARE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:AMIBANG
Authorized Official - Last Name:TANUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-257-3504
Mailing Address - Street 1:6301 IVY LN
Mailing Address - Street 2:SUITE 700-A28
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1402
Mailing Address - Country:US
Mailing Address - Phone:301-257-3504
Mailing Address - Fax:301-257-3501
Practice Address - Street 1:6301 IVY LN
Practice Address - Street 2:SUITE 700-A28
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1402
Practice Address - Country:US
Practice Address - Phone:301-257-3504
Practice Address - Fax:301-257-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities