Healthcare Provider Details

I. General information

NPI: 1962294231
Provider Name (Legal Business Name): CONSTACARE HOME CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3926 FIR RD STE 28
MISHAWAKA IN
46545-4035
US

IV. Provider business mailing address

3926 FIR RD STE 28
MISHAWAKA IN
46545-4035
US

V. Phone/Fax

Practice location:
  • Phone: 574-261-2454
  • Fax:
Mailing address:
  • Phone:
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CHANEL RICHARDS
Title or Position: OWNER
Credential:
Phone: 574-261-2454