Provider Demographics
NPI:1750119673
Name:AGELESS LOVE HOME CARE LLC
Entity type:Organization
Organization Name:AGELESS LOVE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:MYESHIA
Authorized Official - Last Name:MCCLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:463-245-2065
Mailing Address - Street 1:7220 WOODLAND DR STE 104
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1734
Mailing Address - Country:US
Mailing Address - Phone:463-245-2065
Mailing Address - Fax:
Practice Address - Street 1:3960 SOUTHEASTERN AVE STE 600
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-1500
Practice Address - Country:US
Practice Address - Phone:463-245-2065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care