Provider Demographics
NPI:1477388320
Name:PROTECARE CONSULTING LLC
Entity type:Organization
Organization Name:PROTECARE CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAYEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-354-3036
Mailing Address - Street 1:14393 WOLVERTON WAY
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-4421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14393 WOLVERTON WAY
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-4421
Practice Address - Country:US
Practice Address - Phone:317-354-3036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities