Healthcare Provider Details

I. General information

NPI: 1588435028
Provider Name (Legal Business Name): HEALTHYCARE HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7951 CALUMET AVE #1137
MUNSTER IN
46321
US

IV. Provider business mailing address

1746 REDWOOD CT
MUNSTER IN
46321-5165
US

V. Phone/Fax

Practice location:
  • Phone: 219-237-9560
  • Fax:
Mailing address:
  • Phone: 219-237-9560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAWNISE CARTER
Title or Position: OWNER
Credential: SLP.D
Phone: 219-237-9560