Organization
MEMORIAL HOME CARE, INC.
Active
Other names
Family Nursing Services
Organization subpart
No
Provider details
NPI number
Authorized official
GREG CONRAD MBA (VICE PRESIDENT)
(574) 647-8777
Entity
Organization
Contact information
Practice address
58025 COUNTY ROAD 9, ELKHART, IN 46517-2260
(574) 266-3661
Mailing address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1781
(574) 273-2273
(574) 273-5605
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
12-005298-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091080B
—
IN
01
—
100263690C
WAIVER
IN
Enumeration date
09/07/2012
Last updated
03/08/2013
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