# I-CARE PRIVATE HOME CARE SERVICES, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497044416
- **Authorized official:** ALRENE ALLEN-MARTIN RN (CEO)
- **Authorized official phone:** (678) 687-7152

## Contact information

- **Practice address:** 155 WESTRIDGE PKWY, SUITE \#208, MCDONOUGH, GA 30253-3049
- **Practice address phone:** (678) 687-7152
- **Practice address fax:** (678) 509-8103
- **Mailing address:** 155 WESTRIDGE PKWY, SUITE \#208, MCDONOUGH, GA 30253-3049
- **Mailing address phone:** (678) 687-7152
- **Mailing address fax:** (678) 509-8103

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC1500X | Community Health Registered Nurse | 149168 | GA | — |
| 163WG0000X | General Practice Registered Nurse | 149168 | GA | — |
| 163WG0600X | Gerontology Registered Nurse | 149168 | GA | — |
| 163WH0200X | Home Health Registered Nurse | 149168 | GA | Yes |
| 163WH1000X | Hospice Registered Nurse | 149168 | GA | — |
| 163WI0500X | Infusion Therapy Registered Nurse | 149168 | GA | — |
| 163WM0102X | Maternal Newborn Registered Nurse | 149168 | GA | — |
| 163WN1003X | Nutrition Support Registered Nurse | 149168 | GA | — |
| 163WP0000X | Pain Management Registered Nurse | 149168 | GA | — |
| 163WP0200X | Pediatric Registered Nurse | 149168 | GA | — |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | 149168 | GA | — |
| 163WW0000X | Wound Care Registered Nurse | 149168 | GA | — |
| 163WX1500X | Ostomy Care Registered Nurse | 149168 | GA | — |
| 251B00000X | Case Management Agency | 149168 | GA | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 03/30/2011
- **Last updated:** 01/23/2014