Healthcare Provider Details

I. General information

NPI: 1134900608
Provider Name (Legal Business Name): PERSISTENT HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 10/11/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11628 STOEPPELWERTH DR
INDIANAPOLIS IN
46229-4243
US

IV. Provider business mailing address

11628 STOEPPELWERTH DR
INDIANAPOLIS IN
46229-4243
US

V. Phone/Fax

Practice location:
  • Phone: 317-384-6672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SUMMER LYNN HATCHETT
Title or Position: C.E.O
Credential:
Phone: 317-384-6672