Healthcare Provider Details

I. General information

NPI: 1134044381
Provider Name (Legal Business Name): FULL EMBRACE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6433 E WASHINGTON ST STE 105
INDIANAPOLIS IN
46219-6627
US

IV. Provider business mailing address

6433 E WASHINGTON ST STE 105
INDIANAPOLIS IN
46219-6627
US

V. Phone/Fax

Practice location:
  • Phone: 317-590-3363
  • Fax: 317-947-2509
Mailing address:
  • Phone: 317-590-3363
  • Fax: 317-947-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIC RANDOLPH
Title or Position: OWNER
Credential:
Phone: 317-590-3363