Provider Demographics
NPI:1265684567
Name:STAY HOME SENIOR CARE INC
Entity Type:Organization
Organization Name:STAY HOME SENIOR CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLYNEUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-668-8737
Mailing Address - Street 1:119 1/2 W MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-1979
Mailing Address - Country:US
Mailing Address - Phone:260-668-8737
Mailing Address - Fax:260-665-3185
Practice Address - Street 1:119 1/2 W MAUMEE ST
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-1979
Practice Address - Country:US
Practice Address - Phone:260-668-8737
Practice Address - Fax:260-665-3185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN200501610251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health