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General NPI Number Information
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NPI Number | 1770307514
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Entity Type | Organization
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Legal Business Name | HOMEBASE CARE LLC
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 12805 VIKING LANE
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City | FISHER
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State | IN
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Zip | 46037
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Country | US
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Telephone | 317-289-3794
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Fax |
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Provider Business Mailing Address
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Address Line | 9801 FALL CREEK RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-4802
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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
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Name | MRS. RONSHAY WALLS
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Credential |
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Telephone | 317-682-8797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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