Healthcare Provider Details

I. General information

NPI: 1720794209
Provider Name (Legal Business Name): INTEGRATED HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2023
Last Update Date: 01/27/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 COMMERCE PARKWAY SOUTH CAROLINA TPA DIVISION
MIRAMAR FL
33025-3912
US

IV. Provider business mailing address

3700 COMMERCE PARKWAY SOUTH CAROLINA TPA DIVISION
MIRAMAR FL
33025-3912
US

V. Phone/Fax

Practice location:
  • Phone: 844-215-4264
  • Fax: 844-215-4265
Mailing address:
  • Phone: 844-215-4264
  • Fax: 844-215-4265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LINDA JOY MENDEZ
Title or Position: COO
Credential:
Phone: 844-215-4264