Healthcare Provider Details

I. General information

NPI: 1770968570
Provider Name (Legal Business Name): HEALTH WORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7460 E 30TH ST
INDIANAPOLIS IN
46219-1111
US

IV. Provider business mailing address

7460 E 30TH ST
INDIANAPOLIS IN
46219-1111
US

V. Phone/Fax

Practice location:
  • Phone: 317-966-1454
  • Fax:
Mailing address:
  • Phone: 317-966-1454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA1500283
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHHA1500283
License Number StateIN

VIII. Authorized Official

Name: MR. SIDNEY LEON HOLMES
Title or Position: HHA
Credential: CNA/HHA
Phone: 317-966-1454