Healthcare Provider Details

I. General information

NPI: 1497692073
Provider Name (Legal Business Name): PRINCIPLED HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 55TH PL STE 213
INDIANAPOLIS IN
46220-3550
US

IV. Provider business mailing address

2555 55TH PL STE 213
INDIANAPOLIS IN
46220-3550
US

V. Phone/Fax

Practice location:
  • Phone: 317-983-7732
  • Fax: 317-536-3376
Mailing address:
  • Phone: 317-983-7732
  • Fax: 317-536-3376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management 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 TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JERMAINE LAMAR FOSTER
Title or Position: PRESIDENT
Credential:
Phone: 317-983-7732