Healthcare Provider Details
I. General information
NPI: 1063757839
Provider Name (Legal Business Name): ELDERS JOURNEY HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/05/2012
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4334 E 3RD ST STE 100
BLOOMINGTON IN
47401-5547
US
IV. Provider business mailing address
4334 E 3RD ST STE 100
BLOOMINGTON IN
47401-5547
US
V. Phone/Fax
- Phone: 812-334-2389
- Fax: 812-287-8181
- Phone: 812-334-2389
- Fax: 812-287-8181
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANN
MARIE
HARRISON
Title or Position: ADMINISTRATOR/OWNER
Credential: RN, BSN
Phone: 812-334-2389