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General NPI Number Information
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NPI Number | 1003344979
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Entity Type | Organization
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Legal Business Name | MY CARE AT HOME HOME HEALTH CARE SERVICES, LLC
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1516 S HARRISON ST
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City | SHELBYVILLE
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State | IN
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Zip | 46176-2746
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Country | US
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Telephone | 317-559-4230
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Fax | 317-825-0736
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Provider Business Mailing Address
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Address Line | 1516 S HARRISON ST
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City | SHELBYVILLE
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State | IN
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Zip | 46176-2746
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Country | US
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Telephone | 317-559-4230
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Fax | 317-825-0736
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | JOANN KAPUNAN WIKSTEN
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Credential |
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Telephone | 317-559-4230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 16-013957-4
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License Number State | IN
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