Provider Demographics
NPI:1215365291
Name:INNOVATION CARE, LLC
Entity type:Organization
Organization Name:INNOVATION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-455-4176
Mailing Address - Street 1:11700 OLD COLUMBIA PIKE APT 2208
Mailing Address - Street 2:2208
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2559
Mailing Address - Country:US
Mailing Address - Phone:301-455-4176
Mailing Address - Fax:
Practice Address - Street 1:1110 VERMONT AVE NW STE 715
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3544
Practice Address - Country:US
Practice Address - Phone:301-455-4176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion