Healthcare Provider Details

I. General information

NPI: 1316468135
Provider Name (Legal Business Name): IMMACULATE HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5426 WOOD HOLLOW DR
INDIANAPOLIS IN
46239-6899
US

IV. Provider business mailing address

5426 WOOD HOLLOW DR
INDIANAPOLIS IN
46239-6899
US

V. Phone/Fax

Practice location:
  • Phone: 317-527-9715
  • Fax:
Mailing address:
  • Phone: 317-527-9715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANH LAPSLEY
Title or Position: CEO
Credential:
Phone: 317-527-9715