Provider Demographics
NPI:1609179613
Name:CARING CARE HOME SERVICES LLC
Entity Type:Organization
Organization Name:CARING CARE HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:317-842-7942
Mailing Address - Street 1:13267 BRITTON PARK RD STE F
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4534
Mailing Address - Country:US
Mailing Address - Phone:317-842-7942
Mailing Address - Fax:317-842-8198
Practice Address - Street 1:13267 BRITTON PARK RD STE 7
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-4534
Practice Address - Country:US
Practice Address - Phone:317-842-7942
Practice Address - Fax:317-842-8198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10-012476-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care