Provider Demographics
NPI:1447774088
Name:ELDER'S JOURNEY HOME CARE OF WABASH VALLEY INC.
Entity Type:Organization
Organization Name:ELDER'S JOURNEY HOME CARE OF WABASH VALLEY INC.
Other - Org Name:ELDER'S JOURNEY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:812-442-8899
Mailing Address - Street 1:4 W NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:BRAZIL
Mailing Address - State:IN
Mailing Address - Zip Code:47834-2537
Mailing Address - Country:US
Mailing Address - Phone:812-442-8899
Mailing Address - Fax:812-442-8898
Practice Address - Street 1:4 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-2537
Practice Address - Country:US
Practice Address - Phone:812-442-8899
Practice Address - Fax:812-442-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health