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General NPI Number Information
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NPI Number | 1275310948
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Entity Type | Organization
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Legal Business Name | I CARE HOME HEALTH & MENTAL WELLNESS LLC
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 11743 NORTHPOINTE BLVD APT 115
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City | TOMBALL
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State | TX
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Zip | 77377-5575
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Country | US
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Telephone | 832-413-8831
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Fax |
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Provider Business Mailing Address
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Address Line | 11743 NORTHPOINTE BLVD APT 115
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City | TOMBALL
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State | TX
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Zip | 77377-5575
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Country | US
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Telephone | 832-413-8831
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Fax |
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Authorized Official
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Title or Position | C EO
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Name | NICOLETT LATRICE HINES
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Credential |
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Telephone | 832-413-8831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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