Healthcare Provider Details

I. General information

NPI: 1578134797
Provider Name (Legal Business Name): HOPE MANOR LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2021
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8189 E 21ST ST UNIT F
INDIANAPOLIS IN
46219-2576
US

IV. Provider business mailing address

1601 HANDBALL LN APT C
INDIANAPOLIS IN
46260-1078
US

V. Phone/Fax

Practice location:
  • Phone: 281-922-8458
  • Fax: 317-522-1445
Mailing address:
  • Phone: 281-922-8458
  • 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
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ADEDEJI ADESINA
Title or Position: VICE PRESIDENT
Credential:
Phone: 281-922-8458