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Organization
INTEGRATED INTERVENTION SPECIALISTS, LLC
Active
Organization
INTEGRATED INTERVENTION SPECIALISTS, LLC
Active
Parent organization
INTEGRATED INTERVENTION SPECIALISTS, LLC
Other names
Full Circle Pediatric Solutions
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTEGRATED INTERVENTION SPECIALISTS, LLC
Authorized official
RACHEL HAMAN (OWNER)
(701) 799-2045
Entity
Organization
Contact information
Practice address
4725 AMBER VALLEY PKWY S STE B, FARGO, ND 58104-8614
(701) 478-0221
(701) 478-0222
Mailing address
4725 AMBER VALLEY PKWY S STE B, FARGO, ND 58104-8614
(701) 478-0221
(701) 478-0222
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1479549
—
ND
Enumeration date
05/16/2021
Last updated
05/16/2021
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