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General NPI Number Information
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NPI Number | 1982163499
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Entity Type | Organization
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Legal Business Name | ROSEBUD PERSONAL SERVICE AGENCY
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 6301 OLD BARN CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-4045
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Country | US
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Telephone | 317-989-1725
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 68758
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-0758
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Country | US
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Telephone | 317-989-1725
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Fax | 844-296-2291
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | CHRISTA R HENDERSON
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Credential |
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Telephone | 317-989-1725
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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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