Provider Demographics
NPI:1235731514
Name:KRISTY'S HOUSE OF CARE
Entity Type:Organization
Organization Name:KRISTY'S HOUSE OF CARE
Other - Org Name:KRISTYS HOUSE OF CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:LEBRAY
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-520-6131
Mailing Address - Street 1:1761 N SHERMAN DR STE I
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-4492
Mailing Address - Country:US
Mailing Address - Phone:317-600-3031
Mailing Address - Fax:317-344-8960
Practice Address - Street 1:1761 N SHERMAN DR STE I
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-4492
Practice Address - Country:US
Practice Address - Phone:317-006-3031
Practice Address - Fax:317-344-8960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care