Healthcare Provider Details

I. General information

NPI: 1780146803
Provider Name (Legal Business Name): NURSEMADE HOME HEALTHCARE LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W 86TH AVE STE B
MERRILLVILLE IN
46410-7063
US

IV. Provider business mailing address

111 W 86TH AVE STE B
MERRILLVILLE IN
46410-7063
US

V. Phone/Fax

Practice location:
  • Phone: 312-752-6832
  • Fax:
Mailing address:
  • Phone: 312-752-6832
  • Fax:

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 Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA REYNOLDS
Title or Position: PARTNER/ADMINISTRATOR
Credential:
Phone: 312-752-6832