Provider Demographics
NPI:1346991809
Name:ANOINTEDSAINTS HOME HEALTH LLC
Entity Type:Organization
Organization Name:ANOINTEDSAINTS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FATAI
Authorized Official - Middle Name:ADEMOLA
Authorized Official - Last Name:RAJI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:460-206-2107
Mailing Address - Street 1:2368 MEADOW CRK
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-6886
Mailing Address - Country:US
Mailing Address - Phone:317-850-4299
Mailing Address - Fax:
Practice Address - Street 1:2346 S LYNHURST DR STE 605
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-8607
Practice Address - Country:US
Practice Address - Phone:463-206-2107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-15
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN21-015372-1OtherHOME HEALTH AGENCY LICENSE