Healthcare Provider Details

I. General information

NPI: 1336054618
Provider Name (Legal Business Name): IND COMMUNITY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6611 VENTNOR PL
INDIANAPOLIS IN
46217-3003
US

IV. Provider business mailing address

6611 VENTNOR PL
INDIANAPOLIS IN
46217-3003
US

V. Phone/Fax

Practice location:
  • Phone: 317-457-9284
  • Fax:
Mailing address:
  • Phone: 317-457-9284
  • Fax:

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: PENG HLEI THANG
Title or Position: CEO
Credential:
Phone: 317-908-7084