Healthcare Provider Details

I. General information

NPI: 1811603186
Provider Name (Legal Business Name): KOBI HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 E STOP 11 RD STE 9
INDIANAPOLIS IN
46237-8629
US

IV. Provider business mailing address

5150 E STOP 11 RD STE 9
INDIANAPOLIS IN
46237-8629
US

V. Phone/Fax

Practice location:
  • Phone: 317-519-5285
  • Fax:
Mailing address:
  • Phone: 317-519-5285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KASHINDI MSAMBILWA
Title or Position: VICE PRESIDENT
Credential:
Phone: 317-519-5285