Healthcare Provider Details

I. General information

NPI: 1659187847
Provider Name (Legal Business Name): QUALITY COMFORT HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 E 46TH ST STE 116
INDIANAPOLIS IN
46205-1449
US

IV. Provider business mailing address

2201 E 46TH ST STE 116
INDIANAPOLIS IN
46205-1449
US

V. Phone/Fax

Practice location:
  • Phone: 317-993-1883
  • Fax:
Mailing address:
  • Phone: 317-993-1883
  • 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: MRS. LISA WILSON
Title or Position: OWNER
Credential: RN
Phone: 317-993-1883