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General NPI Number Information
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NPI Number | 1497044416
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Entity Type | Organization
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Legal Business Name | I-CARE PRIVATE HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 01/23/2014
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Provider Practice Location Address
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Address Line | 155 WESTRIDGE PKWY SUITE #208
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City | MCDONOUGH
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State | GA
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Zip | 30253-3049
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Country | US
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Telephone | 678-687-7152
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Fax | 678-509-8103
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Provider Business Mailing Address
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Address Line | 155 WESTRIDGE PKWY SUITE #208
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City | MCDONOUGH
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State | GA
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Zip | 30253-3049
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Country | US
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Telephone | 678-687-7152
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Fax | 678-509-8103
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Authorized Official
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Title or Position | CEO
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Name | ALRENE ALLEN-MARTIN
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Credential | RN
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Telephone | 678-687-7152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 149168
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 163WH1000X
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Taxonomy Name | Hospice Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 163WN1003X
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Taxonomy Name | Nutrition Support Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #10
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #11
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #12
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #13
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Taxonomy Code | 163WX1500X
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Taxonomy Name | Ostomy Care Registered Nurse
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License Number | 149168
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License Number State | GA
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Taxonomy #14
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 149168
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License Number State | GA
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