MEDICARE: ATTENDER 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	253Z00000X	In Home Supportive Care Agency	500265	KY

General Provider Information

NPI Number	:	1588195770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATTENDER CARE LLC

Provider Business Mailing Address
First Line	:	1022 HIGHLAND PARK DRIVE
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505
Country	:	US
Telephone Number	:	859-202-3730
Fax Number	:

Provider Business Practice Location Address
First Line	:	1022 HIGHLAND PARK DRIVE
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505
Country	:	US
Telephone Number	:	859-202-3730
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MRS. DANA GEORGEJEAN WYATT
Credential	:	SRNA
Telephone Number	:	859-202-3730

Provider Enumeration Date	:	03/21/2017
Last Update Date	:	03/21/2017

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