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General NPI Number Information
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NPI Number | 1437457611
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Entity Type | Organization
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Legal Business Name | RELIANT@HOME LTD
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 341 LOGAN ST STE L110
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City | NOBLESVILLE
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State | IN
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Zip | 46060-1610
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Country | US
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Telephone | 317-674-8453
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Fax | 317-674-8703
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Provider Business Mailing Address
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Address Line | 9301 S POINTE LASALLES DR
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City | BLOOMINGTON
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State | IN
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Zip | 47401-9011
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Country | US
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Telephone | 855-557-6669
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Fax | 855-557-3291
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Authorized Official
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Title or Position | ADMINISTRATOR/DIRECTOR
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Name | MRS. SHARI L PENTICUFF
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Credential | RN, BSN
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Telephone | 317-674-8453
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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 | 11-012546-1
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License Number State | IN
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