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General NPI Number Information
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NPI Number | 1861948572
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Entity Type | Organization
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Legal Business Name | ICAREPROS, LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 4508 CASSANDRA DRIVE
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City | FLOWER MOUND
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State | TX
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Zip | 75022
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Country | US
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Telephone | 561-516-1548
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Fax |
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Provider Business Mailing Address
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Address Line | 4508 CASSANDRA DR
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City | FLOWER MOUND
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State | TX
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Zip | 75022-0985
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Country | US
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Telephone | 561-516-1548
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | TRINITY ALLAM
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Credential |
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Telephone | 561-516-1548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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