Integrity Support Services, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

39 1532 00 Issued in WA

Legal business name

INTEGRITY SUPPORT SERVICES, LLC

Practice address

303 Division St
Grandview, WA 98930-1358

Phone

(509) 882-8012

Fax

(509) 882-8802

NPI assigned

Mar 30, 2011

Last updated

Mar 30, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gerardo Castilleja, CDPT

Title

Administrator

Phone

(509) 882-8012

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1174812168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 DIVISION ST",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989301358",
            "telephone_number": "509-882-8012",
            "fax_number": "509-882-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 DIVISION ST",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989301358",
            "telephone_number": "509-882-8012",
            "fax_number": "509-882-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITY SUPPORT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "CASTILLEJA",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "509-882-8012",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CDPT"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "39 1532 00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam S Hoverman, DO
• Tess Hudson, PHARMD
• Cecilia Joanna Hunsaker, BSW
• Jaycie Husted
• Adesuwa Ihaza, MD
• Jay Lance James, D.D.S.
• Jay L. James, D.D.S., P.S.
• Thomas Jenkins
• Steve Allen Jimenez II, SUDPT
• Jonathan F Volz DDS PLLC (Valley Family Dentistry)

• Substance Use Disorder Rehabilitation Clinic/Center in Grandview, WA
• Providers in Grandview, WA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.