MEDICARE: TENDERCARE HOME HEALTH 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	251E00000X	Home Health Agency
2	251E00000X	Home Health Agency	40-007519-1	IN

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	:	1821093162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDERCARE HOME HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	6308 RUCKER RD
Second Line	:	STE D
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4881
Country	:	US
Telephone Number	:	317-251-0700
Fax Number	:	317-251-7440

Provider Business Practice Location Address
First Line	:	6308 RUCKER RD
Second Line	:	STE D
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4881
Country	:	US
Telephone Number	:	317-251-0700
Fax Number	:	317-251-7440

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	KELLIE CAMPBELL
Credential	:
Telephone Number	:	317-251-0700

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	10/23/2024

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