Provider Demographics
NPI:1841509072
Name:ICARE FAMILY HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ICARE FAMILY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBOC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-229-1408
Mailing Address - Street 1:20255 N 61ST LN
Mailing Address - Street 2:PO BOX 10115
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7600
Mailing Address - Country:US
Mailing Address - Phone:623-229-1408
Mailing Address - Fax:602-358-7209
Practice Address - Street 1:20255 N 61ST LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7600
Practice Address - Country:US
Practice Address - Phone:623-229-1408
Practice Address - Fax:602-358-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health