Provider Demographics
NPI:1508307661
Name:ICE CARE GROUP LLC
Entity Type:Organization
Organization Name:ICE CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON PIERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-781-9985
Mailing Address - Street 1:11510 ROCKFORD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77048-2615
Mailing Address - Country:US
Mailing Address - Phone:281-781-9985
Mailing Address - Fax:
Practice Address - Street 1:11510 ROCKFORD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77048-2615
Practice Address - Country:US
Practice Address - Phone:281-781-9985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No385H00000XRespite Care FacilityRespite Care