Provider Demographics
NPI:1437911138
Name:ANNIE HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:ANNIE HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:COLLINS
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-674-6515
Mailing Address - Street 1:7708 GOLD RUSH DR
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-7723
Mailing Address - Country:US
Mailing Address - Phone:317-674-6515
Mailing Address - Fax:
Practice Address - Street 1:7708 GOLD RUSH DR
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-7723
Practice Address - Country:US
Practice Address - Phone:317-674-6515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health