1336504877 NPI number — SENIORS HOME HEALTHCARE SERVICES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336504877 NPI number — SENIORS HOME HEALTHCARE SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENIORS HOME HEALTHCARE SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336504877
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5401 MADISON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANAPOLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46227-4245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-986-5332
Provider Business Mailing Address Fax Number:
317-986-5532

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5401 MADISON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46227-4245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-986-5332
Provider Business Practice Location Address Fax Number:
317-986-5532
Provider Enumeration Date:
12/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BRINEGAR
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
31798765332

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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