Healthcare Provider Details

I. General information

NPI: 1437797750
Provider Name (Legal Business Name): RIVERSTONE HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6030 S TACOMA AVE
INDIANAPOLIS IN
46227-4728
US

IV. Provider business mailing address

6030 S TACOMA AVE
INDIANAPOLIS IN
46227-4728
US

V. Phone/Fax

Practice location:
  • Phone: 765-259-2885
  • Fax:
Mailing address:
  • Phone: 765-259-2885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CHARITY DIAZ
Title or Position: PRESIDENT
Credential:
Phone: 765-259-2885