Provider Demographics
NPI:1346766136
Name:INVICTUS HEALTHCARE PLUS LLC
Entity Type:Organization
Organization Name:INVICTUS HEALTHCARE PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EUNITA
Authorized Official - Middle Name:OCTAVIA
Authorized Official - Last Name:HASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-455-6406
Mailing Address - Street 1:5024 MANOR VALLEY CT APT 2
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7330
Mailing Address - Country:US
Mailing Address - Phone:919-455-6406
Mailing Address - Fax:
Practice Address - Street 1:5024 MANOR VALLEY CT
Practice Address - Street 2:APT.002
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7071
Practice Address - Country:US
Practice Address - Phone:919-455-6406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherEIN NUMBER