Provider Demographics
NPI:1447401443
Name:WATCH OVER ME PERSONAL CARE SERVICES LLC
Entity Type:Organization
Organization Name:WATCH OVER ME PERSONAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LENORE
Authorized Official - Middle Name:N
Authorized Official - Last Name:DEPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-724-6337
Mailing Address - Street 1:1915 RED LEAF CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-1997
Mailing Address - Country:US
Mailing Address - Phone:317-724-6337
Mailing Address - Fax:317-894-4928
Practice Address - Street 1:1915 RED LEAF CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-1997
Practice Address - Country:US
Practice Address - Phone:317-724-6337
Practice Address - Fax:317-894-4928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08-011599251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200905990Medicaid