Provider Demographics
NPI:1225474182
Name:CAREGIVER HOMES OF INDIANA INC.
Entity Type:Organization
Organization Name:CAREGIVER HOMES OF INDIANA INC.
Other - Org Name:CAREFORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-797-0673
Mailing Address - Street 1:120 SAINT JAMES AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-5001
Mailing Address - Country:US
Mailing Address - Phone:617-797-0673
Mailing Address - Fax:617-236-7777
Practice Address - Street 1:5975 CASTLE CREEK PARKWAY NORTH DR STE 425
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-4385
Practice Address - Country:US
Practice Address - Phone:617-797-0673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAREGIVER HOMES NETWORK INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-20
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home