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General NPI Number Information
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NPI Number | 1861005639
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Entity Type | Organization
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Legal Business Name | ICARE HOME HEALTH VA LLC
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 208 N 2ND AVE STE 5
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City | HOPEWELL
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State | VA
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Zip | 23860-2703
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Country | US
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Telephone | 267-577-2172
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Fax |
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Provider Business Mailing Address
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Address Line | 251 E GIRARD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3971
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Country | US
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Telephone | 267-577-2172
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRITTANY GORING
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Credential |
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Telephone | 267-577-2172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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