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General NPI Number Information
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NPI Number | 1407483225
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Entity Type | Organization
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Legal Business Name | NDR HOME CARE SERVICE
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 5209 HOHMAN AVE STE 125
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City | HAMMOND
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State | IN
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Zip | 46320-1719
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Country | US
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Telephone | 219-750-1203
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Fax | 219-512-9031
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Provider Business Mailing Address
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Address Line | 5209 HOHMAN AVE STE 125
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City | HAMMOND
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State | IN
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Zip | 46320-1719
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Country | US
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Telephone | 219-750-1203
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Fax | 219-512-9031
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. VANESSA REDD
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Credential |
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Telephone | 219-750-1203
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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 |
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License Number State |
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