Provider Demographics
NPI:1578118469
Name:ICS HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ICS HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-651-2233
Mailing Address - Street 1:7140 W PERSHING CT STE B
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-7941
Mailing Address - Country:US
Mailing Address - Phone:559-651-2233
Mailing Address - Fax:559-651-5191
Practice Address - Street 1:7140 W PERSHING CT STE B
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-7941
Practice Address - Country:US
Practice Address - Phone:559-651-2233
Practice Address - Fax:559-651-5191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health