Healthcare Provider Details

I. General information

NPI: 1679031645
Provider Name (Legal Business Name): ICARE HEALTH SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 RIVERSIDE PKWY STE 213
FREDERICKSBURG VA
22406-1094
US

IV. Provider business mailing address

150 RIVERSIDE PKWY STE 213
FREDERICKSBURG VA
22406-1094
US

V. Phone/Fax

Practice location:
  • Phone: 540-940-6967
  • Fax: 540-940-6963
Mailing address:
  • Phone: 540-940-6967
  • Fax: 540-940-6963

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

VIII. Authorized Official

Name: CATHERINE BONNA
Title or Position: BUSINESS MANAGER
Credential:
Phone: 540-940-6967