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General NPI Number Information
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NPI Number | 1376056911
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Entity Type | Organization
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Legal Business Name | GARDINEA LLC
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 13728 OLIVER LN
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City | CARMEL
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State | IN
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Zip | 46074-8593
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Country | US
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Telephone | 765-381-0371
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Fax |
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Provider Business Mailing Address
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Address Line | 13728 OLIVER LN
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City | CARMEL
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State | IN
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Zip | 46074-8593
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | HRISHIKESH RAIPET
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Credential |
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Telephone | 765-381-0371
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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 | 17-014219-1
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License Number State | IN
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