Organization
INTEGRATED CARE SUPPORT SVCS NC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY PAVELOCK B.A. (QUALIFIED PROFESSIONAL/CASE MANAGER)
(704) 929-8119
Entity
Organization
Contact information
Practice address
96031 BROADMOOR RD, FERNANDINA BEACH, FL 32034
(704) 929-8119
Mailing address
96031 BROADMOOR RD, FERNANDINA BEACH, FL 32034
(704) 929-8119
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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