MEDICARE: PARTNERS IN CHRIST INC, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1174192629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARTNERS IN CHRIST INC, LLC

Provider Business Mailing Address
First Line	:	2222 E MICHIGAN BLVD APT 1
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-5395
Country	:	US
Telephone Number	:	219-210-9284
Fax Number	:	219-533-4157

Provider Business Practice Location Address
First Line	:	2222 E MICHIGAN BLVD APT 1
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-5395
Country	:	US
Telephone Number	:	219-210-9284
Fax Number	:	219-533-4157

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MRS. VERONICA PATRINA GAMEZ
Credential	:	LPN
Telephone Number	:	219-210-9284

Provider Enumeration Date	:	06/20/2021
Last Update Date	:	09/01/2021

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