MEDICARE: LUX BENEDICTA HOME HEALTH SERVICES 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	163WH0200X	Home Health Registered Nurse
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1679420707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUX BENEDICTA HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	8208 CAGLES MILL TRCE
Second Line	:
City	:	AVON
State	:	IN
Zip	:	46123-5912
Country	:	US
Telephone Number	:	463-288-0081
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 S LYNHURST DR STE 106
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46241-5100
Country	:	US
Telephone Number	:	463-288-0081
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. OLADELE OLADIMEJI OYEDELE
Credential	:	PHD, RN
Telephone Number	:	463-288-0081

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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