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General NPI Number Information
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NPI Number | 1902625080
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Entity Type | Organization
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Legal Business Name | K&M DIVINE TOUCH HOME CARE SERVICES
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 6002 W 62ND ST STE 2
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City | INDIANAPOLIS
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State | IN
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Zip | 46278-2909
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Country | US
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Telephone | 317-427-3763
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Fax |
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Provider Business Mailing Address
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Address Line | 5137 RED YARROW WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-5303
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Country | US
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Telephone | 317-427-3763
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | TANIKIA DAWNSHA FORREST
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Credential |
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Telephone | 317-427-3763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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