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General NPI Number Information
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NPI Number | 1982866091
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Entity Type | Organization
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Legal Business Name | HOOSIER HOSPITALITY HOME CARE
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 10809 SPRING GREEN DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46229-3535
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Country | US
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Telephone | 317-895-9245
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Fax |
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Provider Business Mailing Address
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Address Line | 10809 SPRING GREEN DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46229-3535
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Country | US
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Telephone | 317-895-9245
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | KIMBERLY Y DIXON
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Credential | HFA
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Telephone | 317-895-9245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | IN
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