Provider Demographics
NPI:1952696940
Name:INFINITI HOME CARE, LLC
Entity Type:Organization
Organization Name:INFINITI HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:OTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-825-1191
Mailing Address - Street 1:3204 MORTON LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4930
Mailing Address - Country:US
Mailing Address - Phone:919-825-1191
Mailing Address - Fax:919-825-1191
Practice Address - Street 1:300 W ARLINGTON BLVD STE E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5738
Practice Address - Country:US
Practice Address - Phone:919-825-1191
Practice Address - Fax:919-825-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)