Dawnisha T Eldridge
Individual provider Active NPI In Home Supportive Care Agency · Fortville, IN
NPI 1255178463 · NPPES record last updated Aug 26, 2024
Key facts
- NPI
- 1255178463
- Entity type
- Individual (NPI type 1)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- License
- 24-107521-1 (IN)
- Practice address
- 304 Park Creek LN
Fortville, IN 46040-0075 - Phone
- (317) 721-9102
- Fax
- (317) 855-1906
- NPI assigned
- Jul 15, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-107521-1 | IN | MD | Home Health Agency |
| 24-017521-1 | IN | MD | Homemaker |
| 24-10752101 | IN | MD | Homemaker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charlii'S Angels Home Care LLC | Multi-Specialty | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 24-107521-1 | IN | |
| Homemaker |
376J00000X | 24-10752101 | IN | |
| Homemaker | 376J00000X | 24-017521-1 | IN | |
| In Home Supportive Care Agency | 253Z00000X | 24-107521-1 | IN | Yes |
Addresses
Primary practice location
304 Park Creek LN
Fortville, IN 46040-0075
Mailing address
7584 Pennycroft Dr
Indianapolis, IN 46236-8758
Phone (317) 939-8441
Other providers in Fortville, IN
- Ryan Creevy
- Katherine Crowell
- Designher Wellness MD, LLC
- Venessa Dwyer
- Kennth J Eads
- Margaret S Fitzsimmons
- Fortville Chiropractic LLC
- Fortville Family Denistry LLC
- Fortville Smile Station
- Ann M Gang
All providers in Fortville, IN · In Home Supportive Care Agency in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.