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NPI 1366252793

NPI 1366252793 : PROLIFIC HOME CARE SERVICE LLC : INDIANAPOLIS, IN

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General NPI Number Information
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    NPI Number           |    1366252793
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    Entity Type          |    Organization 
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    Legal Business Name  |    PROLIFIC HOME CARE SERVICE LLC 
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Dates
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    Enumeration Date     |    01/08/2025
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    Last Update Date     |    01/08/2025
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Provider Practice Location Address
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    Address Line         |    4448 OZARK LN 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46239-6917
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    Country              |    US
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    Telephone            |    317-665-7242
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4448 OZARK LN 
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    City                 |    INDIANAPOLIS
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    State                |    IN
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    Zip                  |    46239-6917
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    Country              |    US
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    Telephone            |    317-665-7242
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     PROLIFIC HOME CARE SERVICE  LLC 
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    Credential           |    
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    Telephone            |    317-665-7242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3747P1801X
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    Taxonomy Name        |    Personal Care Attendant
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    License Number       |    
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    License Number State |    
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