At Home for You

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

10-012231-1 Issued in IN

Legal business name

AT HOME FOR YOU

Practice address

16462 Shamrock Dr
Mishawaka, IN 46544-6491

Phone

(574) 855-1536

Fax

(574) 855-1099

NPI assigned

Jun 3, 2010

Last updated

Jun 3, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jimmy Dale Grimes, ADMINISTRATOR

Title

President/Ceo

Phone

(574) 855-1536

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275523200000",
    "number": "1669792370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16462 SHAMROCK DR",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465446491",
            "telephone_number": "574-855-1536",
            "fax_number": "574-855-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16462 SHAMROCK DR",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465446491",
            "telephone_number": "574-855-1536",
            "fax_number": "574-855-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT HOME FOR YOU",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "574-855-1536",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": "10-012231-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.