Healthcare Provider Details

I. General information

NPI: 1235968892
Provider Name (Legal Business Name): A WILLING HAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 LEEDS AVE
MICHIGAN CITY IN
46360-3127
US

IV. Provider business mailing address

102 LEEDS AVE
MICHIGAN CITY IN
46360-3127
US

V. Phone/Fax

Practice location:
  • Phone: 219-243-1887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM ELLIOTT
Title or Position: CEO
Credential:
Phone: 219-243-1887