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General NPI Number Information
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NPI Number | 1508850363
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Entity Type | Organization
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Legal Business Name | HOME HEALTH AGENCY INDIANA, LLC
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 215 INDUSTRIAL PKWY
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City | RICHMOND
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State | IN
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Zip | 47374-3707
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Country | US
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Telephone | 765-935-6000
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Fax | 765-962-2222
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Provider Business Mailing Address
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Address Line | PO BOX 51266
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City | LAFAYETTE
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State | LA
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Zip | 70505-1266
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Country | US
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Telephone | 337-233-1307
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Fax | 337-443-4154
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSHUA L PROFFITT
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Credential |
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Telephone | 337-233-1307
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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 | 040443901
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License Number State | IN
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