Provider Demographics
NPI:1245334572
Name:ASSOCIATED HOMECARE INC
Entity type:Organization
Organization Name:ASSOCIATED HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:219-465-6176
Mailing Address - Street 1:2255 STURDY ROAD
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383
Mailing Address - Country:US
Mailing Address - Phone:219-465-6176
Mailing Address - Fax:219-462-4137
Practice Address - Street 1:2255 STURDY ROAD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383
Practice Address - Country:US
Practice Address - Phone:219-465-6176
Practice Address - Fax:219-462-4137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN04006155251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN006155OtherCHOICE
IN157249Medicare ID - Type Unspecified