Healthcare Provider Details

I. General information

NPI: 1639981368
Provider Name (Legal Business Name): PLEASANT LIVING HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2025
Last Update Date: 06/28/2025
Certification Date: 06/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 S LYNHURST DR STE 110
INDIANAPOLIS IN
46241-5100
US

IV. Provider business mailing address

1173 STATION DR
GREENWOOD IN
46143-0010
US

V. Phone/Fax

Practice location:
  • Phone: 317-830-9786
  • Fax: 317-765-0455
Mailing address:
  • Phone: 317-830-9786
  • Fax: 317-765-0455

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 Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: RHATISHIA WATSON
Title or Position: OWNER
Credential:
Phone: 317-830-9786