Integrity Square Behavioral Home

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

INTEGRITY SQUARE BEHAVIORAL HOME

Doing business as

Integrity Square Behavioral Home

Practice address

21398 N Duncan Dr
Maricopa, AZ 85138-2318

Phone

(302) 454-6851

NPI assigned

Sep 5, 2022

Last updated

Sep 5, 2022By 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

Alice K Boateng

Title

Owner

Phone

(302) 602-9779

Specialties & licenses 2

Addresses

Other names 1

• INTEGRITY SQUARE BEHAVIORAL HOME Doing business as

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662336000000",
    "number": "1801517305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21398 N DUNCAN DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851382318",
            "telephone_number": "302-454-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21398 N DUNCAN DR",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851382318",
            "telephone_number": "302-454-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITY SQUARE BEHAVIORAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-03",
        "status": "A",
        "authorized_official_last_name": "BOATENG",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-602-9779"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTEGRITY SQUARE BEHAVIORAL HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility (Behavioral Disturbances) in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Assisted Living Facility (Behavioral Disturbances) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.