Provider Demographics
NPI:1477893006
Name:ATTIC, INC.
Entity Type:Organization
Organization Name:ATTIC, INC.
Other - Org Name:HOME SWEET HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEETWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-281-5777
Mailing Address - Street 1:1721 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-4823
Mailing Address - Country:US
Mailing Address - Phone:877-281-5777
Mailing Address - Fax:812-886-1128
Practice Address - Street 1:1721 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-4823
Practice Address - Country:US
Practice Address - Phone:877-281-5777
Practice Address - Fax:812-886-1128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN012022253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200921130 AMedicaid