Provider Demographics
NPI:1417449471
Name:SIGNAL HEALTH GROUP MEDICAL HHA INC
Entity Type:Organization
Organization Name:SIGNAL HEALTH GROUP MEDICAL HHA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIEM
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHERBACK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:800-260-6145
Mailing Address - Street 1:PO BOX 17460
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-0460
Mailing Address - Country:US
Mailing Address - Phone:800-260-6145
Mailing Address - Fax:888-681-9011
Practice Address - Street 1:10500 CROSSPOINT BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256
Practice Address - Country:US
Practice Address - Phone:800-260-6145
Practice Address - Fax:888-681-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health