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General NPI Number Information
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NPI Number | 1053778571
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Entity Type | Organization
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Legal Business Name | CHANGES HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 10090 E US HIGHWAY 36 SUITE C
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City | AVON
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State | IN
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Zip | 46123-8175
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Country | US
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Telephone | 317-986-6965
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Fax | 317-203-1064
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Provider Business Mailing Address
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Address Line | 10090 E US HIGHWAY 36 SUITE C
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City | AVON
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State | IN
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Zip | 46123-8175
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Country | US
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Telephone | 317-986-6965
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Fax | 317-203-1064
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | CARRIE CLARK
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Credential | REGISTERED NURSE
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Telephone | 317-986-6965
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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 | 150138071
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License Number State | IN
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