Provider Demographics
NPI:1639431232
Name:CARING HANDS PERSONAL SERVICE AGENCY, LLC
Entity Type:Organization
Organization Name:CARING HANDS PERSONAL SERVICE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:574-288-5799
Mailing Address - Street 1:2502 EMERSON FOREST PKWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-3945
Mailing Address - Country:US
Mailing Address - Phone:574-288-5799
Mailing Address - Fax:574-289-5358
Practice Address - Street 1:2502 EMERSON FOREST PKWY
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-3945
Practice Address - Country:US
Practice Address - Phone:574-288-5799
Practice Address - Fax:574-289-5358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11-012403-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care