Provider Demographics
NPI:1023548898
Name:I CARE HOME PROVIDER INC
Entity Type:Organization
Organization Name:I CARE HOME PROVIDER INC
Other - Org Name:I CARE HOME PROVIDER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALEED
Authorized Official - Middle Name:
Authorized Official - Last Name:SADIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-707-1121
Mailing Address - Street 1:29158 LONGVIEW AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2441
Mailing Address - Country:US
Mailing Address - Phone:586-707-1121
Mailing Address - Fax:
Practice Address - Street 1:29158 LONGVIEW AVE APT 12
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2441
Practice Address - Country:US
Practice Address - Phone:586-707-1121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care