MEDICARE: MICHIANA HOME SERVICES, INC.

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

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	:	1417592981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIANA HOME SERVICES, INC.

Provider Business Mailing Address
First Line	:	310 N IRONWOOD DR
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-2520
Country	:	US
Telephone Number	:	574-232-8487
Fax Number	:	574-222-2670

Provider Business Practice Location Address
First Line	:	310 N IRONWOOD DR
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-2520
Country	:	US
Telephone Number	:	574-232-8487
Fax Number	:	574-222-2670

Authorized Official
Title or Position	:	OWNER
Name	:	DANIELLE LOUPEE
Credential	:
Telephone Number	:	574-217-6174

Provider Enumeration Date	:	11/08/2019
Last Update Date	:	07/18/2022

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Directions to “MICHIANA HOME SERVICES, INC. ” Practice Location

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