MEDICARE: WOODS HOME HEALTHCARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1154915635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODS HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	2804 E 55TH PL
Second Line	:	STE H
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3546
Country	:	US
Telephone Number	:	317-279-6363
Fax Number	:

Provider Business Practice Location Address
First Line	:	2804 E 55TH PL
Second Line	:	STE H
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3546
Country	:	US
Telephone Number	:	317-279-6363
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ERICA ENGLEMAN
Credential	:
Telephone Number	:	317-279-6363

Provider Enumeration Date	:	02/24/2021
Last Update Date	:	02/24/2021

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