Provider Demographics
NPI:1205149143
Name:KRISTIN'S CARE LLC
Entity type:Organization
Organization Name:KRISTIN'S CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER OF LLC
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:317-850-2523
Mailing Address - Street 1:9658 GEIST WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-9630
Mailing Address - Country:US
Mailing Address - Phone:317-850-2523
Mailing Address - Fax:317-257-6545
Practice Address - Street 1:9658 GEIST WOODS WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-9630
Practice Address - Country:US
Practice Address - Phone:317-850-2523
Practice Address - Fax:317-257-6545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004141A252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency