MEDICARE: I-CARE AT HOMES, 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

General Provider Information

NPI Number	:	1801305768
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I-CARE AT HOMES, LLC

Provider Business Mailing Address
First Line	:	5317 BELLIS DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4552
Country	:	US
Telephone Number	:	817-675-4954
Fax Number	:

Provider Business Practice Location Address
First Line	:	5317 BELLIS DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-4552
Country	:	US
Telephone Number	:	817-675-4954
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SABINA WAINOGA
Credential	:
Telephone Number	:	817-675-4954

Provider Enumeration Date	:	09/22/2017
Last Update Date	:	07/21/2022

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