Healthcare Provider Details

I. General information

NPI: 1750310462
Provider Name (Legal Business Name): ICETTE HOMECARE COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 PECAN GROVE RD E
SHERMAN TX
75090-1767
US

IV. Provider business mailing address

812 PECAN GROVE RD E
SHERMAN TX
75090-1767
US

V. Phone/Fax

Practice location:
  • Phone: 903-868-3648
  • Fax: 903-892-0067
Mailing address:
  • Phone: 903-868-3648
  • Fax: 903-892-0067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number004629
License Number StateTX

VIII. Authorized Official

Name: AMY STEPHENS
Title or Position: OWNER
Credential:
Phone: 903-785-4900