111Home Health Care Agency
Organization Active NPI In Home Supportive Care Agency · Elkhart, IN
NPI 1376816702 · NPPES record last updated Feb 15, 2012
Key facts
- NPI
- 1376816702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- License
- 11-012725-1 (IN)
- Legal business name
- 111HOME HEALTH CARE AGENCY
- Practice address
- 336 W Garfield Ave
Elkhart, IN 46516-2501 - Phone
- (574) 350-9831
- Fax
- (574) 293-7947
- NPI assigned
- Feb 15, 2012
- Organization subpart
- No
Authorized official
- Name
- Mrs. Lavern I Suggs, CEO
- Title
- Ceo
- Phone
- (574) 350-9831
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- 111 Home Health Care Agency
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 11-012725-1 | IN | Yes |
Addresses
Primary practice location
336 W Garfield Ave
Elkhart, IN 46516-2501
Mailing address
336 W Garfield Ave
Elkhart, IN 46516-2501
Phone (574) 350-9831
Other names
- 111Home Personal Care Agency
Other providers in Elkhart, IN
- 111 Home Health Care Agency
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- Abbott Eye Clinic Inc PC
- Kenneth W Abbott
- Gerald Abell II
- Jad Abou Rjeily
All providers in Elkhart, 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 Feb 15, 2012. 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.