Healthcare Provider Details

I. General information

NPI: 1578245668
Provider Name (Legal Business Name): PURPOSECARE HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 HARRISON PARK LN
INDIANAPOLIS IN
46216-2245
US

IV. Provider business mailing address

5455 HARRISON PARK LN
INDIANAPOLIS IN
46216-2245
US

V. Phone/Fax

Practice location:
  • Phone: 317-802-1164
  • Fax:
Mailing address:
  • Phone: 317-802-1164
  • 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: RICHARD M KELLER
Title or Position: CEO
Credential:
Phone: 317-802-1164