Healthcare Provider Details
I. General information
NPI: 1629084066
Provider Name (Legal Business Name): IN HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2006
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 NOTTINGHAM AVE
WISE VA
24293-5612
US
IV. Provider business mailing address
201 NOTTINGHAM AVE
WISE VA
24293-5612
US
V. Phone/Fax
- Phone: 276-328-9340
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YVONNE
WHITAKER
Title or Position: SECRETARY OF CORP.
Credential:
Phone: 276-328-9340