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General NPI Number Information
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NPI Number | 1497072102
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Entity Type | Organization
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Legal Business Name | AT HOME HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/21/2010
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 6525 E 82ND ST SUITE 210-I
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-1570
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Country | US
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Telephone | 317-523-9320
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Fax | 317-288-5165
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Provider Business Mailing Address
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Address Line | 6525 E 82ND ST SUITE 210-I
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-1570
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Country | US
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Telephone | 317-523-9320
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Fax | 317-288-5165
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. BEVERLY ANN JOHNSON
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Credential |
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Telephone | 317-523-9320
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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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