MEDICARE: HUMBLE CARE LLC

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	:	1134975782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMBLE CARE LLC

Provider Business Mailing Address
First Line	:	11416 PACE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-4139
Country	:	US
Telephone Number	:	317-658-9301
Fax Number	:

Provider Business Practice Location Address
First Line	:	11416 PACE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-4139
Country	:	US
Telephone Number	:	317-658-9301
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANYSHIA WILBURN
Credential	:
Telephone Number	:	317-658-9301

Provider Enumeration Date	:	04/25/2024
Last Update Date	:	04/25/2024

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Directions to “HUMBLE CARE LLC ” Practice Location

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