Southern Indiana Personal Care Agency
In Home Supportive Care in Ellettsville, IN. Organization (NPI-2).
NPI number1356010664
StatusActive
Last updated in NPPESSep 9, 2021
Details
- NPI
- 1356010664
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Indiana Personal Care Agency
- Organization subpart
- No
- Enumeration date
- Sep 9, 2021
- Certification date
- Sep 9, 2021
- Last updated
- Sep 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Practice location
303 E Tecumseh DrEllettsville, IN 47429-1982
Phone 812-803-0359
Mailing address
303 E Tecumseh DrEllettsville, IN 47429-1982
Phone 812-803-0359
Other practice locations
303 E Tecumseh Dr
Ellettsville, IN 47429-1982
Ellettsville, IN 47429-1982
Phone 812-803-0359
Authorized official
Carolyn R Grubb
Administrator
8123183067
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