MEDICARE: IN HOME PERSONAL CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1730919275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN HOME PERSONAL CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	6133 N KEYSTONE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220
Country	:	US
Telephone Number	:	317-220-8203
Fax Number	:

Provider Business Practice Location Address
First Line	:	6331 N ARLINGTON AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236
Country	:	US
Telephone Number	:	317-220-8203
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LATONYA KELLY
Credential	:
Telephone Number	:	317-657-0510

Provider Enumeration Date	:	08/07/2024
Last Update Date	:	08/07/2024

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