Healthcare Provider Details

I. General information

NPI: 1043137037
Provider Name (Legal Business Name): BOOST AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6971 W CEDARWOOD CIR
MCCORDSVILLE IN
46055-8904
US

IV. Provider business mailing address

6971 W CEDARWOOD CIR
MCCORDSVILLE IN
46055-8904
US

V. Phone/Fax

Practice location:
  • Phone: 463-777-2855
  • Fax: 317-676-6475
Mailing address:
  • Phone: 463-777-2855
  • Fax: 317-676-6475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ANDREW THRALL
Title or Position: OWNER
Credential:
Phone: 463-777-2855