Provider Demographics
NPI:1689044232
Name:MICHIANA HOME CARE, LLC
Entity Type:Organization
Organization Name:MICHIANA HOME CARE, LLC
Other - Org Name:MICHIANA HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:EPERESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-272-6024
Mailing Address - Street 1:51099 BITTERSWEET RD STE E
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-4990
Mailing Address - Country:US
Mailing Address - Phone:574-318-3900
Mailing Address - Fax:574-318-3903
Practice Address - Street 1:51099 BITTERSWEET RD STE E
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-4990
Practice Address - Country:US
Practice Address - Phone:574-318-3900
Practice Address - Fax:574-318-3903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN16-013874-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health