Healthcare Provider Details

I. General information

NPI: 1972383909
Provider Name (Legal Business Name): NERTEXTRIYM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1761 N SHERMAN DR
INDIANAPOLIS IN
46218-4498
US

IV. Provider business mailing address

1761 N SHERMAN DR
INDIANAPOLIS IN
46218-4498
US

V. Phone/Fax

Practice location:
  • Phone: 216-268-4348
  • Fax:
Mailing address:
  • Phone: 216-268-4348
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. WLEDOH PAELAY
Title or Position: CEO
Credential: MSN-ED, RN, CNECL
Phone: 614-749-8065