Provider Demographics
NPI:1073181640
Name:ICARE ADULT HOME SERVICES
Entity Type:Organization
Organization Name:ICARE ADULT HOME SERVICES
Other - Org Name:ICARE ADULT HOME SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:OLATUNDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSIBOTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-232-0733
Mailing Address - Street 1:511 MAIN STREET # 156
Mailing Address - Street 2:
Mailing Address - City:CHENANGO BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:13745-0156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:136 E. SERVICE ROAD
Practice Address - Street 2:SUITE 301
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901
Practice Address - Country:US
Practice Address - Phone:607-232-0733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care