Healthcare Provider Details

I. General information

NPI: 1184437089
Provider Name (Legal Business Name): HAMILTON GRACE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8704 MONTERY RD
INDIANAPOLIS IN
46226-5550
US

IV. Provider business mailing address

8704 MONTERY RD
INDIANAPOLIS IN
46226-5550
US

V. Phone/Fax

Practice location:
  • Phone: 317-332-9667
  • Fax:
Mailing address:
  • Phone: 317-332-9667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. OLUWASEUN MODUPE ONIFADE
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 317-332-9667