Organization
GANDA SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RADCLIFFE J.V. GANDA (CEO/OWNER)
(463) 258-5072
Entity
Organization
Contact information
Practice address
4245 LAFAYETTE RD, INDIANAPOLIS, IN 46254-2409
(463) 258-5072
Mailing address
4245 LAFAYETTE RD, INDIANAPOLIS, IN 46254-2409
(463) 258-5072
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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