INTEGRAL CARE NETWORK, LLC (NPI# 1699185108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699185108 |
| Entity Type | Organization |
| Organization Name | INTEGRAL CARE NETWORK, LLC |
| Practice Address |
200 N Nicholls St Waycross GA 31502-1344 |
| Mailing Address |
Po Box 1344 Waycross GA 31502-1344 |
| Practice Telephone | 9122854400 |
| Mailing Telephone | 9122854400 |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2014-05-06 |
| Authorized Official Name | WILLIAM S. PARKS (CEO) |
| Authorized Official Telephone | 9122854400 |
| Authorized Official Credential | ATTORNEY, CPA, J |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
200 N NICHOLLS ST |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31502-1344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700487782 | Lora Christi Dukes | Social Worker | 612 Kenwood Dr, Waycross, GA 31501-6904 | 2020-11-05 |
| 1568071777 | Jacqueline H Moder | Nurse Practitioner | 1912 Memorial Dr Ste E, Waycross, GA 31501-0989 | 2020-07-24 |
| 1740805134 | Kyashirah Barner Wright | Nurse Practitioner | 1410 Roosevelt St, Waycross, GA 31503-4842 | 2020-06-10 |
| 1316569304 | Sabrina Music Smith | Speech-Language Pathologist | 724 Smith Rd, Waycross, GA 31503-6643 | 2020-05-12 |
| 1124649926 | Jessica Delores Johnson | Nurse Practitioner | 360 Ossie Davis Pkwy, Waycross, GA 31501-4566 | 2020-05-03 |
| 1164043055 | Shawana Mitchell Taylor | Nurse Practitioner | 1115 Porter St, Waycross, GA 31501-5640 | 2020-05-01 |
| 1831724160 | Lola A Medlin-goettie | Home Health | 411 Wilkerson St, Waycross, GA 31501-2851 | 2020-03-06 |
| 1700410644 | Emilie Ann King | Nurse Practitioner | 1707 Danora Dr, Waycross, GA 31501-4153 | 2020-03-01 |
| 1154954758 | James Clark | Internal Medicine | 1409 Satilla Blvd, Waycross, GA 31501-4322 | 2020-02-21 |
| 1043841349 | Clemmie Mitchell Flanders | Occupational Therapist | 1701 Boulevard Sq Ste F, Waycross, GA 31501-8022 | 2020-01-27 |
| Find all providers in WAYCROSS | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841626140 | Garden Gate | Community/Behavioral Health | 852 Tiffany Ln, Waycross, GA 31503-0155 | 2013-09-18 |
| 1730454760 | Thomastine Mcgill | Community/Behavioral Health | 201 N Crawford St, Waycross, GA 31503-3932 | 2012-03-08 |
| 1851663074 | Ernestine Nelson | Community/Behavioral Health | 701 Reed St, Waycross, GA 31501-2931 | 2012-02-03 |
| 1750653978 | Flora Brown | Community/Behavioral Health | 821 Cedar St, Waycross, GA 31501-6410 | 2012-02-03 |
| 1881966018 | Christine Smith | Community/Behavioral Health | 908 Cedar St, Waycross, GA 31501-6440 | 2012-02-03 |
| 1225300452 | Supportive Employment | Community/Behavioral Health | 201 Brunel St, Waycross, GA 31501-2216 | 2012-02-03 |
| 1023380243 | Yvonne Thomas | Community/Behavioral Health | 606 Crescent St, Waycross, GA 31501-6321 | 2012-02-03 |
| 1942572169 | Jane Blalock | Community/Behavioral Health | 709 Carswell Ave, Waycross, GA 31501-4756 | 2012-02-03 |
| 1770855868 | Bertha Richardsaon | Community/Behavioral Health | 1614 Carswell Ave, Waycross, GA 31503 | 2012-02-03 |
| 1417229188 | Ware Cs Now | Community/Behavioral Health | 3201 Harris Rd, Waycross, GA 31503-8956 | 2012-01-27 |
| Find all providers in WAYCROSS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.