Provider Demographics
NPI:1871030700
Name:PERSONAL CAREGIVERS OF MICHIANA, INC.
Entity Type:Organization
Organization Name:PERSONAL CAREGIVERS OF MICHIANA, INC.
Other - Org Name:VISITING ANGELS OF MICHIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FINNESSY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-323-6756
Mailing Address - Street 1:2424 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-4562
Mailing Address - Country:US
Mailing Address - Phone:800-239-0714
Mailing Address - Fax:866-542-8721
Practice Address - Street 1:2424 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-4562
Practice Address - Country:US
Practice Address - Phone:800-239-0714
Practice Address - Fax:866-542-8721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN150118221251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health