Provider Demographics
NPI:1558895904
Name:AGED LLC
Entity Type:Organization
Organization Name:AGED LLC
Other - Org Name:VERTICAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-275-1920
Mailing Address - Street 1:1017 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-3220
Mailing Address - Country:US
Mailing Address - Phone:812-275-1920
Mailing Address - Fax:812-279-0073
Practice Address - Street 1:1017 14TH ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-3220
Practice Address - Country:US
Practice Address - Phone:812-275-1920
Practice Address - Fax:812-279-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17-012617-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health