# VINTAGE ROOTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043149727
- **Authorized official:** ASHLEY TURNER RN (OWNER)
- **Authorized official phone:** (765) 748-3775

## Contact information

- **Practice address:** 5401 S COUNTY ROAD 475 E, SELMA, IN 47383-9679
- **Practice address phone:** (765) 748-3775
- **Mailing address:** 5401 S COUNTY ROAD 475 E, SELMA, IN 47383-9679
- **Mailing address phone:** (765) 748-3775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/18/2026
- **Last updated:** 05/18/2026