Healthcare Provider Details

I. General information

NPI: 1770758393
Provider Name (Legal Business Name): TENDERCARE HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6308 RUCKER RD STE D
INDIANAPOLIS IN
46220-4881
US

IV. Provider business mailing address

6308 RUCKER RD STE D
INDIANAPOLIS IN
46220-4881
US

V. Phone/Fax

Practice location:
  • Phone: 317-251-0700
  • Fax: 317-251-7440
Mailing address:
  • Phone: 317-251-0700
  • Fax: 317-251-7440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number070075191
License Number StateIN

VIII. Authorized Official

Name: KELLIE CAMPBELL
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 317-983-1066