Healthcare Provider Details
I. General information
NPI: 1588402697
Provider Name (Legal Business Name): IRIE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2024
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5215 COLLEY AVE STE 126
NORFOLK VA
23508-2172
US
IV. Provider business mailing address
5215 COLLEY AVE STE 126
NORFOLK VA
23508-2172
US
V. Phone/Fax
- Phone: 757-321-4946
- Fax: 757-937-7256
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LATARSHA
BATISTE ROACH
Title or Position: CEO
Credential:
Phone: 757-915-5853