MEDICARE: PERSONAL CAREGIVERS OF MICHIANA, 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	150118221	IN

General Provider Information

NPI Number	:	1871030700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSONAL CAREGIVERS OF MICHIANA, INC.

Provider Business Mailing Address
First Line	:	2424 FRANKLIN ST
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-4562
Country	:	US
Telephone Number	:	800-239-0714
Fax Number	:	866-542-8721

Provider Business Practice Location Address
First Line	:	2424 FRANKLIN ST
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-4562
Country	:	US
Telephone Number	:	800-239-0714
Fax Number	:	866-542-8721

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JOHN FINNESSY
Credential	:
Telephone Number	:	574-323-6756

Provider Enumeration Date	:	01/30/2017
Last Update Date	:	01/30/2017

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