Healthcare Provider Details

I. General information

NPI: 1497345243
Provider Name (Legal Business Name): INFINITY 7EVEN HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BROAD ST STE 104
DURHAM NC
27705-3573
US

IV. Provider business mailing address

1200 BROAD ST STE 104
DURHAM NC
27705-3573
US

V. Phone/Fax

Practice location:
  • Phone: 984-244-9405
  • Fax: 919-972-2992
Mailing address:
  • Phone: 984-244-9405
  • Fax: 919-972-2992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. CHABLIS SHAW
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 984-244-9405