Provider Demographics
NPI:1689390726
Name:NEW START AT HOME CAREGIVERS
Entity Type:Organization
Organization Name:NEW START AT HOME CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PERTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-985-5134
Mailing Address - Street 1:7336 BADGER CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5231
Mailing Address - Country:US
Mailing Address - Phone:317-985-5134
Mailing Address - Fax:
Practice Address - Street 1:7336 BADGER CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5231
Practice Address - Country:US
Practice Address - Phone:317-985-5134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No385H00000XRespite Care FacilityRespite Care