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General NPI Number Information
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NPI Number | 1639053994
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Entity Type | Organization
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Legal Business Name | WILMAR WILLIAMS CARE AGENCY
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 12660 ANTIGUA DR
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City | NOBLESVILLE
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State | IN
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Zip | 46060-4038
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Country | US
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Telephone | 317-937-0963
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 N HIGH SCHOOL RD STE G
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City | INDIANAPOLIS
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State | IN
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Zip | 46224-1100
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Country | US
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Telephone | 317-937-0963
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ICESS MANUEL
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Credential |
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Telephone | 317-937-0963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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