Provider Demographics
NPI:1457457798
Name:HOUSECALLS OF AMERICA, INC.
Entity Type:Organization
Organization Name:HOUSECALLS OF AMERICA, INC.
Other - Org Name:CARETENDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. V.P., ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:LYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-891-1044
Mailing Address - Street 1:9510 ORMSBY STATION RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4081
Mailing Address - Country:US
Mailing Address - Phone:502-891-1000
Mailing Address - Fax:502-891-8067
Practice Address - Street 1:4139 CADILLAC CT
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-1578
Practice Address - Country:US
Practice Address - Phone:502-238-5150
Practice Address - Fax:502-238-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
KY150128251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
1054257OtherPASSPORT MEDICAID HMO
KY42020560Medicaid
KY34025569Medicaid
KYQ4M2433628000OtherPASSPORT ADVANTAGE MC REP
000000054820OtherANTHEM INSURANCE
KY187152Medicare Oscar/Certification