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General NPI Number Information
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NPI Number | 1770932915
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Entity Type | Organization
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Legal Business Name | AGE IN PLACE HOME SERVICES LLC
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 288 HOME ST
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City | HUNTINGTON
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State | IN
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Zip | 46750-1347
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Country | US
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Telephone | 260-200-1407
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Fax | 260-200-1408
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Provider Business Mailing Address
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Address Line | 288 HOME ST
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City | HUNTINGTON
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State | IN
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Zip | 46750-1347
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Country | US
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Telephone | 260-200-1407
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Fax | 260-200-1408
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Authorized Official
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Title or Position | MANAGER
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Name | MS. SUSAN KAY KING
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Credential |
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Telephone | 602-001-4072
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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 | 16-013923-1
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License Number State | IN
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Taxonomy #2
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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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