Healthcare Provider Details

I. General information

NPI: 1184541674
Provider Name (Legal Business Name): DEBBIE'S PROMISE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 E 19TH AVE
GARY IN
46407-2811
US

IV. Provider business mailing address

1131 E 19TH AVE
GARY IN
46407-2811
US

V. Phone/Fax

Practice location:
  • Phone: 414-430-5884
  • Fax: 219-248-5250
Mailing address:
  • Phone: 414-430-5884
  • Fax: 219-239-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBRA LOUISE COOPER
Title or Position: OWNER
Credential:
Phone: 414-430-5884