Provider Demographics
NPI:1801075049
Name:HOOSIER HOMECARE SERVICES, LLC
Entity type:Organization
Organization Name:HOOSIER HOMECARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:DAGGY
Authorized Official - Suffix:
Authorized Official - Credentials:MSOTR
Authorized Official - Phone:765-622-1000
Mailing Address - Street 1:614 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-1727
Mailing Address - Country:US
Mailing Address - Phone:765-622-1000
Mailing Address - Fax:765-622-1002
Practice Address - Street 1:614 E 53RD ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-1727
Practice Address - Country:US
Practice Address - Phone:765-622-1000
Practice Address - Fax:765-622-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health