Healthcare Provider Details

I. General information

NPI: 1679427074
Provider Name (Legal Business Name): BENEVOLENT CARE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 LAKE PLAZA DR STE B215
INDIANAPOLIS IN
46220-4070
US

IV. Provider business mailing address

6801 LAKE PLAZA DR STE B215
INDIANAPOLIS IN
46220-4070
US

V. Phone/Fax

Practice location:
  • Phone: 317-516-1030
  • Fax:
Mailing address:
  • Phone: 317-516-1030
  • Fax: 317-827-2085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MIGNON R HOLDER
Title or Position: CO-OWNER
Credential:
Phone: 317-516-1030