Provider Demographics
NPI:1669782496
Name:ANCHOR HOME CARE, LLC
Entity type:Organization
Organization Name:ANCHOR HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:R.
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSM
Authorized Official - Phone:219-246-2481
Mailing Address - Street 1:1351 SILHAVY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-9513
Mailing Address - Country:US
Mailing Address - Phone:219-531-9400
Mailing Address - Fax:219-464-1066
Practice Address - Street 1:1351 SILHAVY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-9513
Practice Address - Country:US
Practice Address - Phone:219-531-9400
Practice Address - Fax:219-464-1066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10-012356-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health