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General NPI Number Information
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NPI Number | 1003620840
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Entity Type | Organization
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Legal Business Name | MA HOME HEALTH LLC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 5800 FAIRFIELD AVE STE 143
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City | FORT WAYNE
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State | IN
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Zip | 46807-3400
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Country | US
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Telephone | 260-750-1587
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Fax |
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Provider Business Mailing Address
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Address Line | 5800 FAIRFIELD AVE STE 143
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City | FORT WAYNE
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State | IN
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Zip | 46807-3400
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Country | US
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Telephone | 260-750-1587
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT/ADMINISTRATOR
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Name | SACHEEDA MA
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Credential |
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Telephone | 260-750-1587
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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 |
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License Number State |
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