Healthcare Provider Details

I. General information

NPI: 1124806070
Provider Name (Legal Business Name): HAND IN HAND IN-HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 09/20/2023
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12209 BUFFLEHEAD RUN
FORT WAYNE IN
46845-9153
US

IV. Provider business mailing address

PO BOX 214
LEO IN
46765-0214
US

V. Phone/Fax

Practice location:
  • Phone: 260-414-3233
  • Fax: 260-408-6691
Mailing address:
  • Phone: 260-414-3233
  • Fax: 260-408-6691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: DONALD E MAURICE JR.
Title or Position: MEMBER
Credential:
Phone: 260-414-3233