Organization Active NPI

Retro Home Health Care Services,LLC

  • Developmentally Disabled Services Day Training Agency
  • Indianapolis, IN
National Provider Identifier
1790978039
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
RETRO HOME HEALTH CARE SERVICES,LLC
Practice address
4084 Pendleton Way
PMB 172
Indianapolis, IN 46226-5224
Phone
(317) 270-7117
Fax
(317) 869-0982
NPI assigned
Aug 21, 2007
Last updated
Aug 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Authorized official

Name
Mrs. Michelle Andrea Cherry
Title
Chief Executive Officer
Phone
(317) 270-7117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU Primary

Addresses

Primary practice location

4084 Pendleton Way
PMB 172
Indianapolis, IN 46226-5224

Mailing address

4084 Pendleton Way
PMB 172
Indianapolis, IN 46226-5224
Phone (317) 270-7117

Other identifiers 1

IdentifierTypeStateIssuer
25100000XMedicaidIN

National Provider Directory

National Provider Directory

Locations

4084 Pendleton Way
Indianapolis, IN 46226
Phone (317) 270-7117

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1790978039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4084 PENDLETON WAY",
            "address_2": "PMB 172",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462265224",
            "telephone_number": "317-270-7117",
            "fax_number": "317-869-0982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4084 PENDLETON WAY",
            "address_2": "PMB 172",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462265224",
            "telephone_number": "317-270-7117",
            "fax_number": "317-869-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETRO HOME HEALTH CARE SERVICES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "CHERRY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "ANDREA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "317-270-7117",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25100000X",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.