Provider Demographics
NPI:1043607211
Name:ICARE HOME HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:ICARE HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OBIOMA
Authorized Official - Middle Name:MARYANN
Authorized Official - Last Name:ASIEGBU RN BSN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-380-2256
Mailing Address - Street 1:408 BETHEL RD STE B-4
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-2183
Mailing Address - Country:US
Mailing Address - Phone:609-380-2256
Mailing Address - Fax:844-422-7373
Practice Address - Street 1:408 BETHEL RD STE B-4
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2183
Practice Address - Country:US
Practice Address - Phone:609-380-2256
Practice Address - Fax:844-422-7373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0202700251E00000X
251J00000X, 251T00000X, 253Z00000X, 385H00000X, 385HR2060X, 385HR2065X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0523712Medicaid
NJ408OtherPRIVATE PAY