Organization
INTEGRAL INTERACTIVE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA C MILLISCM (ASSISTIVE MEMBER)
(620) 605-1381
Entity
Organization
Contact information
Practice address
606 MAIN ST, NEODESHA, KS 66757-1633
(620) 605-1381
Mailing address
606 MAIN ST, NEODESHA, KS 66757-1633
(620) 605-1381
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
IN PROGRESS
KS
253Z00000X
In Home Supportive Care Agency
IN PROGRESS
KS
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
IN PROGRESS
KS
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
IN PROGRESS
KS
347C00000X
Private Vehicle
IN PROGRESS
KS
385H00000X
Respite Care
IN PROGRESS
KS
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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