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CARE AT HOME LLC NPI 1164984597


NPI Information

NPI: 1164984597
Provider Name: CARE AT HOME LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
717 WASHINGTON PARK BLVD
MICHIGAN CITY, IN
ZIP 46360
Phone: (219) 229-1630
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CARE AT HOME LLC is a primary care nurse practitioner in Michigan City, IN. CARE AT HOME LLC NPI is 1164984597. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

717 WASHINGTON PARK BLVD
MICHIGAN CITY, IN
ZIP 46360-056
Phone: (219) 229-1630

The provider's authorized official is Raelonda M Woodard .
The authorized official title is President and has the following contact phone number (219) 229-1630.

The enumeration date for this NPI number is 4/4/2019 and was last updated on 4/4/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LP2300XNurse PractitionerPrimary CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11386960599MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.