Provider Demographics
NPI:1528847829
Name:LANDMARK INTEGRATED HEALTH SERVICES
Entity type:Organization
Organization Name:LANDMARK INTEGRATED HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-539-5015
Mailing Address - Street 1:9 QUANTUM WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-8450
Mailing Address - Country:US
Mailing Address - Phone:501-539-5015
Mailing Address - Fax:
Practice Address - Street 1:9 QUANTUM WAY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22406-8450
Practice Address - Country:US
Practice Address - Phone:501-539-5015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities