Provider Demographics
NPI:1326371600
Name:SOUTHERN INDIANA SENIOR CARE, INC
Entity Type:Organization
Organization Name:SOUTHERN INDIANA SENIOR CARE, INC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MNGR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARROWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-961-2222
Mailing Address - Street 1:676 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-2527
Mailing Address - Country:US
Mailing Address - Phone:812-961-2222
Mailing Address - Fax:
Practice Address - Street 1:676 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2527
Practice Address - Country:US
Practice Address - Phone:812-961-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN09-011762-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200948510Medicaid