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General NPI Number Information
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NPI Number | 1639989460
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Entity Type | Organization
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Legal Business Name | SOVEREIGN CARE HOME HEALTH LLC
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 9511 ANGOLA CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1119
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Country | US
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Telephone | 317-654-4609
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Fax |
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Provider Business Mailing Address
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Address Line | 11410 PACE CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46229-4139
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Country | US
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Telephone | 317-654-4609
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATAYA COOK
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Credential | PMP
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Telephone | 317-654-4609
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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 |
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License Number State |
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