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General NPI Number Information
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NPI Number | 1619253218
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Entity Type | Organization
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Legal Business Name | LILLIE BELL AND TINDER CARE
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Dates
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Enumeration Date | 10/26/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 3118 W 21ST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-4802
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Country | US
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Telephone | 317-636-2334
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Fax |
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Provider Business Mailing Address
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Address Line | 3118 W 21ST STREET
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City | INDIANAPOLIS
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State | IN
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Zip | 46222
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Country | US
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Telephone | 317-640-0654
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | MRS. JAMIE L HARRIS
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Credential |
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Telephone | 317-640-0654
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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 | CNA0403210
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | CNA0800385
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License Number State | IN
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