Healthcare Provider Details

I. General information

NPI: 1427823822
Provider Name (Legal Business Name): ICARE ELDER SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 11/16/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 N MAIN AVE STE 210
SCRANTON PA
18504-3307
US

IV. Provider business mailing address

219 N MAIN AVE STE 210
SCRANTON PA
18504-3307
US

V. Phone/Fax

Practice location:
  • Phone: 570-445-4570
  • Fax:
Mailing address:
  • Phone: 570-445-4570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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 TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: OLATUNDE OSIBOTE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 570-445-4570