Integral Care Network, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INTEGRAL CARE NETWORK, LLC

Practice address

200 N Nicholls St
Waycross, GA 31502-1344

Phone

(912) 285-4400

NPI assigned

May 6, 2014

Last updated

May 6, 2014By 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

William S. Parks, ATTORNEY, CPA, JD

Title

Ceo

Phone

(912) 285-4400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1699185108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1344",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315021344",
            "telephone_number": "912-285-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N NICHOLLS ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315021344",
            "telephone_number": "912-285-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAL CARE NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-285-4400",
        "authorized_official_credential": "ATTORNEY, CPA, JD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.