MEDICARE: CHERISHED AND LOVED COMPANION SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	372600000X	Adult Companion
2	376J00000X	Homemaker
3	376K00000X	Nurse's Aide
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1063264661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHERISHED AND LOVED COMPANION SERVICES LLC

Provider Business Mailing Address
First Line	:	5014 E NEW YORK ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3714
Country	:	US
Telephone Number	:	463-237-0244
Fax Number	:

Provider Business Practice Location Address
First Line	:	5014 E NEW YORK ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3714
Country	:	US
Telephone Number	:	463-237-0244
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AGENCY MANAGER
Name	:	MS. TAMMI HAZEL HINTON
Credential	:
Telephone Number	:	463-237-0244

Provider Enumeration Date	:	04/05/2024
Last Update Date	:	04/05/2024

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