Provider Demographics
NPI:1689024713
Name:PALMS CLEANING INC
Entity Type:Organization
Organization Name:PALMS CLEANING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-941-9220
Mailing Address - Street 1:5381 BRASSIE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-6014
Mailing Address - Country:US
Mailing Address - Phone:317-941-9220
Mailing Address - Fax:
Practice Address - Street 1:9165 OTIS AVE
Practice Address - Street 2:SUITE 213
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46216-2027
Practice Address - Country:US
Practice Address - Phone:317-941-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN15-013806-1253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201358770 AOtherLEGACY PROVIDER IDENTIFIER