Integration Group Home LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Mansfield, TX. Organization (NPI-2).
NPI number1861236440
StatusActive
Last updated in NPPESJun 19, 2024
Details
- NPI
- 1861236440
- Entity type
- Organization (NPI-2)
- Legal business name
- Integration Group Home LLC
- Organization subpart
- No
- Enumeration date
- Jun 19, 2024
- Certification date
- Jun 19, 2024
- Last updated
- Jun 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Practice location
4800 San Remo DrMansfield, TX 76063-8642
Phone 612-227-5811
Mailing address
4800 San Remo DrMansfield, TX 76063-8642
Phone 612-227-5811
Authorized official
Stephanie Ndifor Fomekon
Ceo/Manager
6122275811
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