=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619797511
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KIND HEARTED EXPERTS HOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/15/2024
-----------------------------------------------------
Last Update Date | 10/15/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6527 CAMARILLO CT
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46278-2939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-240-7920
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6527 CAMARILLO CT
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46278-2939
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-240-7920
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LACHELLE NICOLE STRICKLEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 765-240-7920
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------