Healthcare Provider Details

I. General information

NPI: 1093638991
Provider Name (Legal Business Name): STAY PUT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 MICHIGAN ST APT 204
HAMMOND IN
46320-1248
US

IV. Provider business mailing address

518 MICHIGAN ST APT 204
HAMMOND IN
46320-1248
US

V. Phone/Fax

Practice location:
  • Phone: 219-902-7408
  • Fax:
Mailing address:
  • Phone: 219-902-7408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: TIARA CAMPBELL
Title or Position: OWNER
Credential:
Phone: 219-902-7408