1801195649 NPI number — INTEGRITY BEHAVIORAL MANAGEMENT, LLC

Table of content: (NPI 1801195649)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801195649 NPI number — INTEGRITY BEHAVIORAL MANAGEMENT, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTEGRITY BEHAVIORAL MANAGEMENT, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801195649
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5610 READ BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70127-3106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-248-2681
Provider Business Mailing Address Fax Number:
504-248-2681

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5610 READ BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70127-3106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-241-8188
Provider Business Practice Location Address Fax Number:
504-264-5941
Provider Enumeration Date:
03/18/2011

Additional Information

Authorized Official

Authorized Official Last Name:
WIGGINS-LAIN
Authorized Official First Name:
KATRICE
Authorized Official Middle Name:
V
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
504-241-8188

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  40453949K , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com