Provider Demographics
NPI:1952148207
Name:TRUE IDENTITY HOME CARE LLC.
Entity type:Organization
Organization Name:TRUE IDENTITY HOME CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-771-3006
Mailing Address - Street 1:11310 CUYAHOGA DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-8830
Mailing Address - Country:US
Mailing Address - Phone:317-771-3006
Mailing Address - Fax:
Practice Address - Street 1:11310 CUYAHOGA DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-8830
Practice Address - Country:US
Practice Address - Phone:317-771-3006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care