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General NPI Number Information
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NPI Number | 1770304297
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Entity Type | Organization
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Legal Business Name | PRAISE HOME HEALTH AGENCY LLC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 8214 SIESTA WAY
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City | LOUISVILLE
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State | KY
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Zip | 40219-3827
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Country | US
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Telephone | 317-371-7477
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Fax |
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Provider Business Mailing Address
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Address Line | 7713 MISTY MEADOW DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46217-5359
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | MANG EM
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Credential |
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Telephone | 317-371-7477
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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 |
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License Number State |
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