Healthcare Provider Details

I. General information

NPI: 1922994334
Provider Name (Legal Business Name): I CARE FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 TRAIL RIDGE RD STE 115
AIKEN SC
29803-7765
US

IV. Provider business mailing address

900 TRAIL RIDGE RD STE 115
AIKEN SC
29803-7765
US

V. Phone/Fax

Practice location:
  • Phone: 980-777-3980
  • Fax:
Mailing address:
  • Phone: 980-777-3980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RAVEN SAMA BRODEN
Title or Position: OWNER
Credential:
Phone: 980-777-3980