MEDICARE: INTEGRICARE HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	385HR2055X	Child Mental Illness Respite Care
3	385H00000X	Respite Care
4	163WH0200X	Home Health Registered Nurse
5	261QM0855X	Adolescent and Children Mental Health Clinic/Center
6	261QD1600X	Developmental Disabilities Clinic/Center
7	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1750233011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRICARE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	128 S TRYON ST STE 1900
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-5009
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 S TRYON ST STE 1900
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-5009
Country	:	US
Telephone Number	:	704-828-5746
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGING MEMBER
Name	:	MARY EVANS
Credential	:	RN
Telephone Number	:	704-828-5746

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/24/2026

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