Provider Demographics
NPI:1851429104
Name:INCARE HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:INCARE HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:DUHAMELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-896-0442
Mailing Address - Street 1:425 JOLIET ST
Mailing Address - Street 2:SUITE 312
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1765
Mailing Address - Country:US
Mailing Address - Phone:800-896-0442
Mailing Address - Fax:219-322-7538
Practice Address - Street 1:425 JOLIET ST
Practice Address - Street 2:SUITE 312
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1765
Practice Address - Country:US
Practice Address - Phone:800-896-0442
Practice Address - Fax:219-322-7538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
IN10-007377-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN6353700001Medicare NSC
IN157596Medicare PIN