MEDICARE: CATHERINE ROSE HOME CARE AGENCY

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	:	1972349579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHERINE ROSE HOME CARE AGENCY

Provider Business Mailing Address
First Line	:	6110 W 25TH ST UNIT 241201
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46224-9998
Country	:	US
Telephone Number	:	317-748-4647
Fax Number	:

Provider Business Practice Location Address
First Line	:	7212 N SHADELAND AVE STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-5901
Country	:	US
Telephone Number	:	317-748-4647
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LAVESE DANIEL
Credential	:
Telephone Number	:	317-748-4647

Provider Enumeration Date	:	07/02/2024
Last Update Date	:	06/21/2025

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