=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366248718
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PAIGE HOME HEALTH CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2025
-----------------------------------------------------
Last Update Date | 02/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4806 E 30TH ST
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46218-3110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-426-5876
-----------------------------------------------------
Fax | 317-426-2168
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 18016
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46218-0016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-426-5876
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. NAKISHA RENEE PAIGE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 317-426-5876
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------