MEDICARE: ELITE HEARTS PLATINUM HOME CARE 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1568304699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE HEARTS PLATINUM HOME CARE LLC

Provider Business Mailing Address
First Line	:	1166 BURDSAL PKWY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5469
Country	:	US
Telephone Number	:	317-909-0384
Fax Number	:

Provider Business Practice Location Address
First Line	:	1166 BURDSAL PKWY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5469
Country	:	US
Telephone Number	:	317-909-0384
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MS. SHANTORIA TAYLOR
Credential	:
Telephone Number	:	317-909-0384

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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