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General NPI Number Information
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NPI Number | 1205875424
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Entity Type | Organization
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Legal Business Name | ST. VINCENT HOME CARE, LLC
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 8909 PURDUE RD STE 107
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-3146
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Country | US
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Telephone | 317-829-2122
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Fax | 844-724-7536
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Provider Business Mailing Address
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Address Line | 8450 N PAYNE RD SUITE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-6620
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Country | US
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Telephone | 317-338-9696
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Fax |
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Authorized Official
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Title or Position | SVP, CHIEF LEGAL OFFICER
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Name | RUSSELL ADKINS
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Credential |
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Telephone | 408-658-2768
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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 | 050050751
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License Number State | IN
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