Provider Demographics
NPI:1174011662
Name:THE CAMDEN HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:THE CAMDEN HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-525-5237
Mailing Address - Street 1:2621 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5234
Mailing Address - Country:US
Mailing Address - Phone:219-525-5237
Mailing Address - Fax:
Practice Address - Street 1:2621 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5234
Practice Address - Country:US
Practice Address - Phone:219-525-5237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18-014311-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty