Provider Demographics
NPI:1265872972
Name:IN HOMECARE NETWORK NORTH, LLC
Entity type:Organization
Organization Name:IN HOMECARE NETWORK NORTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PROFFITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:PO BOX 51266
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1266
Mailing Address - Country:US
Mailing Address - Phone:337-233-1307
Mailing Address - Fax:337-443-4154
Practice Address - Street 1:2509 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3241
Practice Address - Country:US
Practice Address - Phone:765-651-3242
Practice Address - Fax:765-651-3246
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IN HOMECARE NETWORK NORTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-26
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN157554Medicare Oscar/Certification