Healthcare Provider Details

I. General information

NPI: 1417158742
Provider Name (Legal Business Name): JPK SENIOR CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6960 GRAY RD STE F
INDIANAPOLIS IN
46237-3237
US

IV. Provider business mailing address

5602 MADISON AVE
INDIANAPOLIS IN
46227-4625
US

V. Phone/Fax

Practice location:
  • Phone: 317-536-0231
  • Fax:
Mailing address:
  • Phone: 317-536-0231
  • Fax: 317-536-0232

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: MR. JOHN P KINDRED
Title or Position: OWNER
Credential:
Phone: 317-536-0231