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NPI 1104620897

NPI 1104620897 : CARRIESANGELSLLC : INDIANAPOLIS, IN

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General NPI Number Information
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    NPI Number           |    1104620897
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    Entity Type          |    Organization 
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    Legal Business Name  |    CARRIESANGELSLLC 
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Dates
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    Enumeration Date     |    04/02/2025
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    Last Update Date     |    04/02/2025
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Provider Practice Location Address
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    Address Line         |    1620 BLACKMORE DR 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46231-4226
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    Country              |    US
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    Telephone            |    317-416-8052
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1620 BLACKMORE DR 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46231-4226
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    Country              |    US
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    Telephone            |    317-416-8052
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     RHUETTA  SANDIFER 
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    Credential           |    
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    Telephone            |    317-417-8052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    253Z00000X
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    Taxonomy Name        |    In Home Supportive Care Agency
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    License Number       |    
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    License Number State |    
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