Healthcare Provider Details

I. General information

NPI: 1689044232
Provider Name (Legal Business Name): MICHIANA HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51099 BITTERSWEET RD STE E
GRANGER IN
46530-4990
US

IV. Provider business mailing address

51099 BITTERSWEET RD STE E
GRANGER IN
46530-4990
US

V. Phone/Fax

Practice location:
  • Phone: 574-318-3900
  • Fax: 574-318-3903
Mailing address:
  • Phone: 574-318-3900
  • Fax: 574-318-3903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number16-013874-1
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MIKE EPERESI
Title or Position: CFO
Credential:
Phone: 724-272-6024