MEDICARE: NAI DELIGHTFUL 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1760267025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAI DELIGHTFUL HOME CARE LLC

Provider Business Mailing Address
First Line	:	1834 EMBASSY DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-3722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1834 EMBASSY DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46816-3722
Country	:	US
Telephone Number	:	260-760-0816
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAI SAR
Credential	:
Telephone Number	:	260-760-0816

Provider Enumeration Date	:	08/25/2023
Last Update Date	:	08/25/2023

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