Healthcare Provider Details

I. General information

NPI: 1790626190
Provider Name (Legal Business Name): FIRSTCARE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2346 S LYNHURST DR
INDIANAPOLIS IN
46241-8621
US

IV. Provider business mailing address

2346 S LYNHURST DR
INDIANAPOLIS IN
46241-8621
US

V. Phone/Fax

Practice location:
  • Phone: 317-225-2155
  • Fax:
Mailing address:
  • Phone: 317-225-2155
  • 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: MR. CARVELL GORDON SR.
Title or Position: ADMINISTRATOR
Credential: BSN, RN
Phone: 317-225-2155