Healthcare Provider Details

I. General information

NPI: 1043905730
Provider Name (Legal Business Name): GANVIE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7212 N SHADELAND AVE
INDIANAPOLIS IN
46250-2074
US

IV. Provider business mailing address

7212 N SHADELAND AVE STE 222A
INDIANAPOLIS IN
46250-2030
US

V. Phone/Fax

Practice location:
  • Phone: 317-665-2000
  • Fax: 317-854-9283
Mailing address:
  • Phone: 317-665-2000
  • Fax: 317-854-9283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLIE R STOWE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 317-345-1250