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General NPI Number Information
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NPI Number | 1639431232
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Entity Type | Organization
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Legal Business Name | CARING HANDS PERSONAL SERVICE AGENCY, LLC
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 2502 EMERSON FOREST PKWY
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City | SOUTH BEND
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State | IN
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Zip | 46614-3945
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Country | US
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Telephone | 574-288-5799
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Fax | 574-289-5358
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Provider Business Mailing Address
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Address Line | 2502 EMERSON FOREST PKWY
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City | SOUTH BEND
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State | IN
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Zip | 46614-3945
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Country | US
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Telephone | 574-288-5799
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Fax | 574-289-5358
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Authorized Official
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Title or Position | C.E.O.
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Name | MISS MICHELLE DENISE ANDERSON
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Credential | C.N.A.
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Telephone | 574-288-5799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 11-012403-1
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License Number State | IN
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