Provider Demographics
NPI:1093409351
Name:HOME OF MY OWN LLC
Entity Type:Organization
Organization Name:HOME OF MY OWN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RASHEEDAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:463-336-2128
Mailing Address - Street 1:6339 PINEBARK PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-8815
Mailing Address - Country:US
Mailing Address - Phone:463-336-2128
Mailing Address - Fax:
Practice Address - Street 1:6339 PINEBARK PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-8815
Practice Address - Country:US
Practice Address - Phone:463-336-2128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care