MEDICARE: MANY BLESSINGS HOME AGENCY 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	:	1174998637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANY BLESSINGS HOME AGENCY LLC

Provider Business Mailing Address
First Line	:	11323 FALLS CHURCH DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2399
Country	:	US
Telephone Number	:	317-724-4964
Fax Number	:

Provider Business Practice Location Address
First Line	:	11323 FALLS CHURCH DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2399
Country	:	US
Telephone Number	:	317-724-4964
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. REGINALD DALE TIPTON
Credential	:
Telephone Number	:	317-724-4964

Provider Enumeration Date	:	12/09/2015
Last Update Date	:	12/09/2015

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