=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427931294
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ENTYRE CARE INDIANA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2025
-----------------------------------------------------
Last Update Date | 07/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 334 N SENATE AVE
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46204-1708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-320-2253
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 711 ATLANTIC AVE FL 6
-----------------------------------------------------
City | BOSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02111-2809
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-320-2253
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OPERATING OFFICER
-----------------------------------------------------
Name | MR. BENEDIKT REIGER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 617-320-2253
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------