Provider Demographics
NPI:1417701525
Name:INFAMOUS HOME CARE LLC
Entity Type:Organization
Organization Name:INFAMOUS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:463-266-0328
Mailing Address - Street 1:3907 ELMONTE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-5536
Mailing Address - Country:US
Mailing Address - Phone:463-266-0328
Mailing Address - Fax:317-723-3141
Practice Address - Street 1:3907 ELMONTE CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-5536
Practice Address - Country:US
Practice Address - Phone:463-266-0328
Practice Address - Fax:317-723-3141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care