Provider Demographics
NPI:1346861655
Name:INTELACARE PBC
Entity type:Organization
Organization Name:INTELACARE PBC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:R
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-957-0110
Mailing Address - Street 1:2200 WILSON BLVD STE 102-205
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-3397
Mailing Address - Country:US
Mailing Address - Phone:703-957-0110
Mailing Address - Fax:
Practice Address - Street 1:2200 WILSON BLVD STE 102-205
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3397
Practice Address - Country:US
Practice Address - Phone:703-957-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health