Provider Demographics
NPI:1356941876
Name:ANN'S PERSONAL CARE SERVICES LLC
Entity type:Organization
Organization Name:ANN'S PERSONAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MUIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-473-8180
Mailing Address - Street 1:3902 N COLLEGE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-2735
Mailing Address - Country:US
Mailing Address - Phone:317-473-8180
Mailing Address - Fax:
Practice Address - Street 1:3902 N COLLEGE AVE STE 205
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2735
Practice Address - Country:US
Practice Address - Phone:317-473-8180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300028578Medicaid