Healthcare Provider Details

I. General information

NPI: 1770093460
Provider Name (Legal Business Name): NORTHERN INDIANA HOME HEALTHCARE SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 04/27/2020
Certification Date: 04/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7870 BROADWAY STE G
MERRILLVILLE IN
46410-5542
US

IV. Provider business mailing address

7870 BROADWAY STE G
MERRILLVILLE IN
46410-5542
US

V. Phone/Fax

Practice location:
  • Phone: 219-750-9642
  • Fax:
Mailing address:
  • Phone: 219-750-9642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: HELEN CAROLINE ABIOYE
Title or Position: PRESIDENT
Credential:
Phone: 219-750-9642