MEDICARE: NEIGHBORHOOD HOME CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194556993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD HOME CARE LLC

Provider Business Mailing Address
First Line	:	4416 ALVERADO DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-1610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4416 ALVERADO DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-1610
Country	:	US
Telephone Number	:	412-892-6131
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DAMBAR KAFLEY
Credential	:
Telephone Number	:	412-892-6131

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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