MEDICARE: ESSENTIAL HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1831934215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL HOME CARE INC

Provider Business Mailing Address
First Line	:	6535 E 82ND ST STE 215
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-4519
Country	:	US
Telephone Number	:	317-918-2909
Fax Number	:

Provider Business Practice Location Address
First Line	:	6801 LAKE PLAZA DR STE B202
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4064
Country	:	US
Telephone Number	:	317-918-2909
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FAIS JAMA
Credential	:
Telephone Number	:	317-918-2909

Provider Enumeration Date	:	06/27/2024
Last Update Date	:	01/10/2025

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