Convenient Care Home Service LLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

CONVENIENT CARE HOME SERVICE LLC

Practice address

120 E Market St Ste 613
Indianapolis, IN 46204-3264

Phone

(713) 281-5253

NPI assigned

Sep 26, 2024

Organization subpart

No

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

Authorized official

Name

Ajia Williams

Title

Owner

Phone

(713) 281-5253

Specialties & licenses 1

Addresses

Other names 1

• CONVENIENT CARE HOME SERVICE LLC Former legal business name

Locations

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1952129264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E MARKET ST STE 613",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462043264",
            "telephone_number": "713-281-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E MARKET ST STE 613",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462043264",
            "telephone_number": "713-281-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENT CARE HOME SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "AJIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-281-5253"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONVENIENT CARE HOME SERVICE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Cristina Contreras Burrola, DPHIL
• Tiari Contreras
• Aaylah Conway, RBT
• Gary Lee Conway, LMHC
• Hailey Conway
• Holly Conway
• Kiah Abeni Conway, BS

• PACE Provider Organization in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• PACE Provider Organization in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.