MEDICARE: VOCA OF INDIANA 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	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285752782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOCA OF INDIANA LLC

Provider Business Mailing Address
First Line	:	805 N WHITTINGTON PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-7101
Country	:	US
Telephone Number	:	800-866-0860
Fax Number	:

Provider Business Practice Location Address
First Line	:	3814 WALDEN RUN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-5260
Country	:	US
Telephone Number	:	812-273-0523
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT MANAGER
Name	:	DENISHA CONNOR
Credential	:
Telephone Number	:	502-630-7421

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	11/14/2024

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Directions to “VOCA OF INDIANA LLC ” Practice Location

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