Provider Demographics
NPI:1619730934
Name:REPUTABLE CARE HOME SERVICES
Entity Type:Organization
Organization Name:REPUTABLE CARE HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CIERRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILSON-ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-413-6377
Mailing Address - Street 1:11158 CLEARSPRING WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-8881
Mailing Address - Country:US
Mailing Address - Phone:317-395-9040
Mailing Address - Fax:
Practice Address - Street 1:11158 CLEARSPRING WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-8881
Practice Address - Country:US
Practice Address - Phone:317-413-6377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health