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General NPI Number Information
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NPI Number | 1073050258
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE HOME HEALTHCARE, INC.
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 5455 W 86TH ST SUITE 108
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1536
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Country | US
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Telephone | 317-757-5368
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 53341
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City | INDIANAPOLIS
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State | IN
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Zip | 46253-0341
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Country | US
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Telephone | 317-757-5368
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS ITHREAM M BLACKMON
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Credential |
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Telephone | 317-757-5368
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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 | 17-014114-1
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License Number State | IN
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