MEDICARE: LOVING ARMS HOMECARE 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	:	1275361800
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING ARMS HOMECARE LLC

Provider Business Mailing Address
First Line	:	4063 LASSEN LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-8836
Country	:	US
Telephone Number	:	317-918-9048
Fax Number	:

Provider Business Practice Location Address
First Line	:	4063 LASSEN LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-8836
Country	:	US
Telephone Number	:	317-918-9048
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATREASE N KELLY
Credential	:	RN
Telephone Number	:	317-918-9048

Provider Enumeration Date	:	07/24/2024
Last Update Date	:	07/24/2024

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