1770836652 NPI number — INDIANA HOME CARE SERVICES LLC

Table of content: STEPHANIE CHAPIN (NPI 1710629746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770836652 NPI number — INDIANA HOME CARE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INDIANA HOME CARE SERVICES LLC
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:
6
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:
1770836652
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8455 KEYSTONE XING
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:
46240-4353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-536-1731
Provider Business Mailing Address Fax Number:
463-212-8855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8455 KEYSTONE XING
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:
46240-4353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-536-1731
Provider Business Practice Location Address Fax Number:
463-212-8855
Provider Enumeration Date:
10/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
DONA
Authorized Official Middle Name:
B
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
317-536-1731

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  120125811 , 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)

  • Identifier: 120125811 . This is a "INDIANA STATE LICENSURE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com