MEDICARE: PINNACLE SENIOR CARE 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	251E00000X	Home Health Agency	16-013954-1	IN

General Provider Information

NPI Number	:	1316308497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNACLE SENIOR CARE OF INDIANA, LLC

Provider Business Mailing Address
First Line	:	500 KIRTS BLVD
Second Line	:	ATTN: CREDENTIALING DEPARTMENT
City	:	TROY
State	:	MI
Zip	:	48084-4134
Country	:	US
Telephone Number	:	248-824-6584
Fax Number	:	855-618-6655

Provider Business Practice Location Address
First Line	:	9100 PURDUE RD
Second Line	:	STE. 110
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1172
Country	:	US
Telephone Number	:	317-982-6024
Fax Number	:	844-410-7961

Authorized Official
Title or Position	:	PRESIDENT HOME HEALTH & HOSPICE
Name	:	SCOTT VASEY
Credential	:
Telephone Number	:	609-781-1535

Provider Enumeration Date	:	03/16/2016
Last Update Date	:	06/12/2024

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