MEDICARE: CARE TEAM STRUCTURED FAMILY CAREGIVING, 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

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	:	1477219509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE TEAM STRUCTURED FAMILY CAREGIVING, LLC

Provider Business Mailing Address
First Line	:	6433 E WASHINGTON ST STE 154
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-6627
Country	:	US
Telephone Number	:	317-742-9300
Fax Number	:	317-742-9393

Provider Business Practice Location Address
First Line	:	6433 E WASHINGTON ST STE 154
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-6627
Country	:	US
Telephone Number	:	317-742-9300
Fax Number	:	317-742-9393

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	CHRISTINE CATHALEEN STEPHENS
Credential	:	RN
Telephone Number	:	317-752-7821

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	07/08/2023

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