Provider Demographics
NPI:1659520567
Name:INFINITE CARE HOME HEALTH
Entity Type:Organization
Organization Name:INFINITE CARE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-742-3247
Mailing Address - Street 1:6445 RISING SUN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-5228
Mailing Address - Country:US
Mailing Address - Phone:215-742-3247
Mailing Address - Fax:
Practice Address - Street 1:6445 RISING SUN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-5228
Practice Address - Country:US
Practice Address - Phone:215-742-3247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INFINITECARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA01980501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health