Healthcare Provider Details

I. General information

NPI: 1568167344
Provider Name (Legal Business Name): INFINITY PLUS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 RUNAWAY BAY CIR APT 1B
MISHAWAKA IN
46545-8056
US

IV. Provider business mailing address

314 RUNAWAY BAY CIR APT 1B
MISHAWAKA IN
46545-8056
US

V. Phone/Fax

Practice location:
  • Phone: 574-300-1190
  • Fax:
Mailing address:
  • Phone: 574-300-1190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. PHILLIP NEWTON MWANZA
Title or Position: CEO
Credential:
Phone: 574-300-1190