Provider Demographics
NPI:1073897070
Name:RELIABLE PERSONAL CARE SERVICES, LLC
Entity Type:Organization
Organization Name:RELIABLE PERSONAL CARE SERVICES, LLC
Other - Org Name:RELIABLE HOME HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERRON
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:317-375-8530
Mailing Address - Street 1:2141 N FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-2435
Mailing Address - Country:US
Mailing Address - Phone:317-375-8530
Mailing Address - Fax:317-894-9887
Practice Address - Street 1:2141 N FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-2435
Practice Address - Country:US
Practice Address - Phone:317-375-8530
Practice Address - Fax:317-894-9887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-09
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN13-012999-1251E00000X
IN11-012074-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN12-012074-1OtherINDIANA STATE DEPARTMENT OF HEALTH
IN12-012999-1OtherINDIANA STATE DEPARTMENT OF HEALTH
IN15D2044947OtherCLIA
IN200930770OtherLPI