Provider Demographics
NPI:1215389986
Name:CONVERGENCE HOME HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:CONVERGENCE HOME HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:765-278-1724
Mailing Address - Street 1:1612 DREXEL DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-3117
Mailing Address - Country:US
Mailing Address - Phone:765-278-1724
Mailing Address - Fax:
Practice Address - Street 1:1612 DREXEL DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3117
Practice Address - Country:US
Practice Address - Phone:765-278-1724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health