Healthcare Provider Details

I. General information

NPI: 1063166353
Provider Name (Legal Business Name): PATIENCE'S COMPASSIONATE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2022
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MUNICIPAL DR STE 200
FISHERS IN
46038-1634
US

IV. Provider business mailing address

11 MUNICIPAL DR STE 200
FISHERS IN
46038-1634
US

V. Phone/Fax

Practice location:
  • Phone: 317-798-9921
  • Fax:
Mailing address:
  • Phone: 317-798-9921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: PATIENCE PINKY CARTER
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 317-798-9921