Provider Demographics
NPI:1538219282
Name:INTEGRATED PROGRAMS AND SERVICES, INC.
Entity type:Organization
Organization Name:INTEGRATED PROGRAMS AND SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRBY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-648-2918
Mailing Address - Street 1:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27533-0315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:906 EAST ELM STREET
Practice Address - Street 2:SUITE B
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530
Practice Address - Country:US
Practice Address - Phone:919-648-2918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8301635Medicaid