Provider Demographics
NPI:1568570711
Name:INFINITE HOMECARE, INC.
Entity Type:Organization
Organization Name:INFINITE HOMECARE, INC.
Other - Org Name:INFINITE WELLNESS AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAINOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-593-2801
Mailing Address - Street 1:5304 PANOLA INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE J
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-4065
Mailing Address - Country:US
Mailing Address - Phone:770-593-2801
Mailing Address - Fax:770-593-9995
Practice Address - Street 1:5304 PANOLA INDUSTRIAL BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-4065
Practice Address - Country:US
Practice Address - Phone:770-593-2801
Practice Address - Fax:770-593-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA116862261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA116862Medicare ID - Type UnspecifiedOPT FACILITY