Healthcare Provider Details

I. General information

NPI: 1740008721
Provider Name (Legal Business Name): CUDDLY CARE PERSONAL CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 FRANKLIN ST
MICHIGAN CITY IN
46360-3764
US

IV. Provider business mailing address

1410 FRANKLIN ST
MICHIGAN CITY IN
46360-3764
US

V. Phone/Fax

Practice location:
  • Phone: 219-243-7810
  • Fax: 888-984-9144
Mailing address:
  • Phone: 219-243-7810
  • Fax: 888-984-9144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ELENA DUNCAN-CRUMB
Title or Position: PRESIDENT
Credential:
Phone: 219-243-7810