Provider Demographics
NPI:1336909605
Name:INFINITY FAMILY CARE LLC
Entity Type:Organization
Organization Name:INFINITY FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:GORHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-417-6829
Mailing Address - Street 1:878 W STAR ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-0844
Mailing Address - Country:US
Mailing Address - Phone:252-417-6829
Mailing Address - Fax:252-298-5413
Practice Address - Street 1:203 0LDWELL DRIVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-417-6829
Practice Address - Fax:252-298-5413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities