Healthcare Provider Details

I. General information

NPI: 1942091962
Provider Name (Legal Business Name): CARE AT HOME SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11516 SEGUNDO PL
FISHERS IN
46040-9047
US

IV. Provider business mailing address

11516 SEGUNDO PL
FISHERS IN
46040-9047
US

V. Phone/Fax

Practice location:
  • Phone: 317-513-8553
  • Fax:
Mailing address:
  • Phone: 317-572-5697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DR. TAMIKA BULLOCK
Title or Position: COO
Credential: DBA/HCA, MSM
Phone: 317-201-4338