Provider Demographics
NPI:1649092198
Name:EBERHARDT, LUKE CHARLES
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:CHARLES
Last Name:EBERHARDT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19478 LINKS LN
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-6662
Mailing Address - Country:US
Mailing Address - Phone:714-345-5230
Mailing Address - Fax:
Practice Address - Street 1:6038 N KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2590
Practice Address - Country:US
Practice Address - Phone:714-345-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care