Provider Demographics
NPI:1063852317
Name:APEX HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:APEX HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:O
Authorized Official - Last Name:DAFIAGHOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-712-9567
Mailing Address - Street 1:5625 HOHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46320-1954
Mailing Address - Country:US
Mailing Address - Phone:219-937-5952
Mailing Address - Fax:219-852-6225
Practice Address - Street 1:5625 HOHMAN AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-1954
Practice Address - Country:US
Practice Address - Phone:219-937-5952
Practice Address - Fax:219-852-6225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN13-013184-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN13-013184-1OtherHOME HEALTH LICENSE