Provider Demographics
NPI:1346255940
Name:COMMUNITY HOME HEALTH NETWORK OF INDIANA, LLC
Entity Type:Organization
Organization Name:COMMUNITY HOME HEALTH NETWORK OF INDIANA, LLC
Other - Org Name:ELARA CARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE AND PRIVACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONASTIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-379-1600
Mailing Address - Street 1:3010 LYNDON B JOHNSON FWY STE 1100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2712
Mailing Address - Country:US
Mailing Address - Phone:800-379-1600
Mailing Address - Fax:903-537-8420
Practice Address - Street 1:2130 W SYCAMORE ST STE 240
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-6461
Practice Address - Country:US
Practice Address - Phone:765-452-1411
Practice Address - Fax:765-452-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
IN16-011284-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157586OtherMEDICARE PTAN
IN157586OtherMEDICARE PTAN