Healthcare Provider Details

I. General information

NPI: 1922511807
Provider Name (Legal Business Name): INCARE HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 E SIR FRANCIS DRAKE BLVD STE 212
LARKSPUR CA
94939-1727
US

IV. Provider business mailing address

17 E SIR FRANCIS DRAKE BLVD
LARKSPUR CA
94939-1727
US

V. Phone/Fax

Practice location:
  • Phone: 415-673-8989
  • Fax:
Mailing address:
  • Phone: 415-927-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMES KELLY
Title or Position: CFO
Credential:
Phone: 415-526-5520