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NPI Code Detail

MEDICARE: JEWELS HOME CARE LLC

MEDICARE: JEWELS 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1417893918
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEWELS HOME CARE LLC
Provider Business Mailing Address
First Line : 1615 E WALLACE ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46803-2564
Country : US
Telephone Number : 260-615-5215
Fax Number :
Provider Business Practice Location Address
First Line : 1615 E WALLACE ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46803-2564
Country : US
Telephone Number : 260-615-5215
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : YOLANDA L GRIGSBY
Credential :
Telephone Number : 260-579-0394
Provider Enumeration Date : 04/27/2026
Last Update Date : 04/27/2026

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Directions to “JEWELS HOME CARE LLC ” Practice Location

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