Healthcare Provider Details

I. General information

NPI: 1851515274
Provider Name (Legal Business Name): HOUSECALLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 E LAKE DR S
ELKHART IN
46514-4327
US

IV. Provider business mailing address

3003 E LAKE DR S
ELKHART IN
46514-4327
US

V. Phone/Fax

Practice location:
  • Phone: 574-206-0465
  • Fax: 574-262-5217
Mailing address:
  • Phone: 574-206-0465
  • Fax: 574-262-5217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KELLY ANNETTE SMOTHERS
Title or Position: PARTNER
Credential:
Phone: 574-206-0465