Provider Demographics
NPI:1699023754
Name:1 ON 1 HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:1 ON 1 HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NEVEROSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-324-2223
Mailing Address - Street 1:2468 N STATE ROAD 39
Mailing Address - Street 2:SUITE D
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-2062
Mailing Address - Country:US
Mailing Address - Phone:219-324-2223
Mailing Address - Fax:219-324-2224
Practice Address - Street 1:2468 N STATE ROAD 39
Practice Address - Street 2:SUITE D
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-2062
Practice Address - Country:US
Practice Address - Phone:219-324-2223
Practice Address - Fax:219-324-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health