Healthcare Provider Details

I. General information

NPI: 1346166071
Provider Name (Legal Business Name): HOPEWELL HOMESTEAD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1282 N SANDHILL RD
COVINGTON IN
47932-8075
US

IV. Provider business mailing address

1282 N SANDHILL RD
COVINGTON IN
47932-8075
US

V. Phone/Fax

Practice location:
  • Phone: 765-263-9792
  • Fax: 765-291-2012
Mailing address:
  • Phone: 765-263-9792
  • Fax: 765-291-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID SHELBY
Title or Position: OFFIC MANAGER
Credential:
Phone: 765-366-2525