Healthcare Provider Details

I. General information

NPI: 1912477860
Provider Name (Legal Business Name): ICARE HOME HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 W 25TH ST # F-6
NORFOLK VA
23517-1000
US

IV. Provider business mailing address

1035 W 25TH ST # F-6
NORFOLK VA
23517-1000
US

V. Phone/Fax

Practice location:
  • Phone: 757-222-5609
  • Fax: 757-227-4332
Mailing address:
  • Phone: 757-222-5609
  • Fax: 757-227-4332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MISS MARVINA R PIGFORD
Title or Position: ADMINISTRATOR
Credential: LPN
Phone: 757-222-5609