MEDICARE: DEWAN HOME 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	385H00000X	Respite Care
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1164251419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEWAN HOME CARE, LLC

Provider Business Mailing Address
First Line	:	5455 W 86TH ST
Second Line	:	SUITE 240
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1538
Country	:	US
Telephone Number	:	317-646-2512
Fax Number	:

Provider Business Practice Location Address
First Line	:	5455 W 86TH ST
Second Line	:	SUITE 240
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1538
Country	:	US
Telephone Number	:	317-646-2512
Fax Number	:

Authorized Official
Title or Position	:	OPS MANAGER
Name	:	MRS. KARLA LEGG
Credential	:
Telephone Number	:	317-646-2512

Provider Enumeration Date	:	07/26/2024
Last Update Date	:	12/30/2024

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