MEDICARE: IRIE HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1588402697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRIE HOME CARE LLC

Provider Business Mailing Address
First Line	:	5215 COLLEY AVE STE 126
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508-2172
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5215 COLLEY AVE STE 126
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508-2172
Country	:	US
Telephone Number	:	757-321-4946
Fax Number	:	757-937-7256

Authorized Official
Title or Position	:	CEO
Name	:	LATARSHA BATISTE ROACH
Credential	:
Telephone Number	:	757-915-5853

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	01/19/2026

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Directions to “IRIE HOME CARE LLC ” Practice Location

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