Provider Demographics
NPI:1467642967
Name:MIDWEST RESIDENTIAL SERVICES, INC.
Entity Type:Organization
Organization Name:MIDWEST RESIDENTIAL SERVICES, INC.
Other - Org Name:MIDWEST HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-920-9352
Mailing Address - Street 1:2425 N MERIDIAN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46208-5823
Mailing Address - Country:US
Mailing Address - Phone:317-920-9352
Mailing Address - Fax:
Practice Address - Street 1:2425 N MERIDIAN ST
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-5823
Practice Address - Country:US
Practice Address - Phone:317-920-9352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health