Healthcare Provider Details

I. General information

NPI: 1528849130
Provider Name (Legal Business Name): CATER TO YOU RESIDENTIAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3142 E MAIN ST
PLAINFIELD IN
46168-2721
US

IV. Provider business mailing address

1681 EXPO LN STE D
INDIANAPOLIS IN
46214-4310
US

V. Phone/Fax

Practice location:
  • Phone: 888-599-5271
  • Fax: 317-458-2467
Mailing address:
  • Phone: 317-742-9240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CARMELITA SMITH
Title or Position: CEO
Credential:
Phone: 317-742-9240