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General NPI Number Information
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NPI Number | 1033690227
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Entity Type | Organization
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Legal Business Name | YOUR LIFE MATTERS HOME CARE
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 2118 W 2ND ST APT 113B
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City | MARION
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State | IN
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Zip | 46952-3281
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Country | US
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Telephone | 765-243-2601
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Fax |
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Provider Business Mailing Address
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Address Line | 2118 W 2ND ST APT 113B
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City | MARION
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State | IN
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Zip | 46952-3281
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Country | US
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Telephone | 765-243-2601
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. ROBBIE SHEVETTE MCCAIN-FICKLIN
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Credential |
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Telephone | 765-243-2601
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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 | IN
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