Provider Demographics
NPI:1770230773
Name:1 PASSION TO CARE INDIANA, LLC
Entity type:Organization
Organization Name:1 PASSION TO CARE INDIANA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NPI MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELAZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HUISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-418-7484
Mailing Address - Street 1:5565 GLENRIDGE CONNECTOR STE 500
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4796
Mailing Address - Country:US
Mailing Address - Phone:678-967-8600
Mailing Address - Fax:317-672-0009
Practice Address - Street 1:8604 ALLISONVILLE RD STE 325
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-0048
Practice Address - Country:US
Practice Address - Phone:317-537-1811
Practice Address - Fax:317-672-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care