Active NPI
Senior Haven Home Care
Doing business as Home Instead Senior Care
- Home Health Agency
- La Porte, IN
National Provider Identifier
1114461464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- IC 16-27-4
- Legal business name
- SENIOR HAVEN HOME CARE
- Doing business as
- Home Instead Senior Care
- Practice address
- 513 Pine Lake Ave
La Porte, IN 46350-2316 - Phone
- (219) 326-1082
- Fax
- (219) 326-1413
- NPI assigned
- Dec 6, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rachel Ann McDermott, PTA
- Title
- Owner/President
- Phone
- (563) 599-7674
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | IC 16-27-4 | IN | Primary |
Addresses
Primary practice location
513 Pine Lake Ave
La Porte, IN 46350-2316
Mailing address
513 Pine Lake Ave
La Porte, IN 46350-2316
Phone (219) 326-1082
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201364430 | Other | IN | MEDICAID LPI |
| IC-16-27-4 | Other | IN | PERSONAL SERVICES AGENCY LICENSE |
Other names 1
- Home Instead Senior Care
National Provider Directory
National Provider DirectoryLocations
513 Pine Lake Ave
La Porte, IN 46350
Phone (219) 326-1082
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Personal Care Attendant
- La Porte, IN
- NPI 1780126573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1480982400000",
"number": "1114461464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 PINE LAKE AVE",
"city": "LA PORTE",
"state": "IN",
"postal_code": "463502316",
"telephone_number": "219-326-1082",
"fax_number": "219-326-1413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 PINE LAKE AVE",
"city": "LA PORTE",
"state": "IN",
"postal_code": "463502316",
"telephone_number": "219-326-1082",
"fax_number": "219-326-1413"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR HAVEN HOME CARE",
"organizational_subpart": "NO",
"enumeration_date": "2016-12-06",
"last_updated": "2016-12-06",
"status": "A",
"authorized_official_last_name": "MCDERMOTT",
"authorized_official_first_name": "RACHEL",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "563-599-7674",
"authorized_official_credential": "PTA"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IN",
"license": "IC 16-27-4",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID LPI",
"identifier": "201364430",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL SERVICES AGENCY LICENSE",
"identifier": "IC-16-27-4",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Home Instead Senior Care",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in La Porte, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.