Provider Demographics
NPI:1487750857
Name:INTEGRATED FAMILY SERVICES, PLLC
Entity type:Organization
Organization Name:INTEGRATED FAMILY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:MANLEY- ROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-209-0388
Mailing Address - Street 1:2000- E NASH STREET
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896
Mailing Address - Country:US
Mailing Address - Phone:252-246-1009
Mailing Address - Fax:252-246-9252
Practice Address - Street 1:2000 E NASH STREET
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896
Practice Address - Country:US
Practice Address - Phone:252-246-1009
Practice Address - Fax:252-246-9252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005390Medicaid