Provider Demographics
NPI:1922746189
Name:INFINITY HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:INFINITY HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-261-9497
Mailing Address - Street 1:1520 19TH AVE SUITES 2
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501
Mailing Address - Country:US
Mailing Address - Phone:334-564-1620
Mailing Address - Fax:
Practice Address - Street 1:1520 19TH AVE SUITES 2
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501
Practice Address - Country:US
Practice Address - Phone:334-564-1620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health