MEDICARE: ICARE HOME HEALTH CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	232919	FL

General Provider Information

NPI Number	:	1225377724
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 15142
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33416-5142
Country	:	US
Telephone Number	:	561-282-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	5112 SOCIETY PL W APT C
Second Line	:
City	:	WEST PALM BCH
State	:	FL
Zip	:	33415
Country	:	US
Telephone Number	:	561-282-8005
Fax Number	:

Authorized Official
Title or Position	:	MGR
Name	:	SHAUNTE BROWN
Credential	:
Telephone Number	:	561-282-8005

Provider Enumeration Date	:	02/05/2013
Last Update Date	:	02/05/2013

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