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General NPI Number Information
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NPI Number | 1003043878
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Entity Type | Organization
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Legal Business Name | YOUR HOME CARE SOLUTION INC
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 06/18/2009
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Provider Practice Location Address
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Address Line | 3617 MISHAWAKA AVE
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City | SOUTH BEND
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State | IN
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Zip | 46615-2425
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Country | US
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Telephone | 574-298-2006
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Fax | 574-289-4555
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Provider Business Mailing Address
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Address Line | 3617 MISHAWAKA AVE
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City | SOUTH BEND
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State | IN
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Zip | 46615-2425
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Country | US
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Telephone | 574-298-2006
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Fax | 574-289-4555
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Authorized Official
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Title or Position | OWNER
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Name | MS. KATHERINE KELLY DEVINE
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Credential |
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Telephone | 574-298-2006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 09-012137-1
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License Number State | IN
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