Provider Demographics
NPI:1972621399
Name:INFINITE CARE HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:INFINITE CARE HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHIQUANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCBRIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-374-5088
Mailing Address - Street 1:10888 ROCK COAST RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2734
Mailing Address - Country:US
Mailing Address - Phone:202-374-5088
Mailing Address - Fax:
Practice Address - Street 1:3126 MILTON RD
Practice Address - Street 2:SUITE 217
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3778
Practice Address - Country:US
Practice Address - Phone:704-566-3737
Practice Address - Fax:704-566-3736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3620374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418379Medicaid