Organization
CARE AT HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAELONDA M WOODARD FNP-BC (PRESIDENT)
(219) 229-1630
Entity
Organization
Contact information
Practice address
717 WASHINGTON PARK BLVD, MICHIGAN CITY, IN 46360-2056
(219) 229-1630
Mailing address
717 WASHINGTON PARK BLVD, MICHIGAN CITY, IN 46360-2056
(219) 229-1630
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386960599
—
IN
Enumeration date
04/04/2019
Last updated
04/04/2019
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