Provider Demographics
NPI:1861005639
Name:ICARE HOME HEALTH VA LLC
Entity Type:Organization
Organization Name:ICARE HOME HEALTH VA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:GORING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-577-2172
Mailing Address - Street 1:251 E GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-3971
Mailing Address - Country:US
Mailing Address - Phone:267-577-2172
Mailing Address - Fax:
Practice Address - Street 1:208 N 2ND AVE STE 5
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2703
Practice Address - Country:US
Practice Address - Phone:267-577-2172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care