Healthcare Provider Details
I. General information
NPI: 1386229516
Provider Name (Legal Business Name): ALTERNATIVE HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2021
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
920 N SHADELAND AVE STE G1A
INDIANAPOLIS IN
46219-4817
US
IV. Provider business mailing address
11722 STILL HAVEN CT
INDIANAPOLIS IN
46229-3974
US
V. Phone/Fax
- Phone: 317-646-6734
- Fax: 317-947-7437
- Phone: 317-646-6734
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTIAN
PARKER
Title or Position: OWNER
Credential:
Phone: 317-646-6734