Healthcare Provider Details

I. General information

NPI: 1659280253
Provider Name (Legal Business Name): OAK GROVE PATHWAYS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1461 SEDONA DR
CARMEL IN
46032-8358
US

IV. Provider business mailing address

1461 SEDONA DR
CARMEL IN
46032-8358
US

V. Phone/Fax

Practice location:
  • Phone: 317-558-9305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KERSTYN KEMP
Title or Position: ADMINISTRATOR
Credential:
Phone: 317-410-6122