MEDICARE: GRATEFUL HEARTS HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1134943590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRATEFUL HEARTS HOME CARE

Provider Business Mailing Address
First Line	:	3618 E 25TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-3847
Country	:	US
Telephone Number	:	317-998-5787
Fax Number	:

Provider Business Practice Location Address
First Line	:	3618 E 25TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-3847
Country	:	US
Telephone Number	:	317-998-5787
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YOLANDA LYNN CARTER
Credential	:
Telephone Number	:	317-998-5787

Provider Enumeration Date	:	11/12/2024
Last Update Date	:	11/12/2024

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