Provider Demographics
NPI:1659653087
Name:ADVOCATE HOME HEALTH OF INDIANA, INC
Entity Type:Organization
Organization Name:ADVOCATE HOME HEALTH OF INDIANA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:GAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:219-937-7324
Mailing Address - Street 1:7330 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-2941
Mailing Address - Country:US
Mailing Address - Phone:219-937-7324
Mailing Address - Fax:219-937-7325
Practice Address - Street 1:7330 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-2941
Practice Address - Country:US
Practice Address - Phone:219-937-7324
Practice Address - Fax:219-937-7325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health