Provider Demographics
NPI:1649036161
Name:JILL C KENDRAT
Entity type:Organization
Organization Name:JILL C KENDRAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:KENDRAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-384-6069
Mailing Address - Street 1:301 E CARMEL DR STE H300
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4825
Mailing Address - Country:US
Mailing Address - Phone:317-427-5522
Mailing Address - Fax:
Practice Address - Street 1:301 E CARMEL DR STE H300
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4825
Practice Address - Country:US
Practice Address - Phone:317-427-5522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care