Organization
111 HOME HEALTH CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAVERN I SUGGS LPN (CEO)
(574) 293-6682
Entity
Organization
Contact information
Practice address
336 W GARFIELD AVE, ELKHART, IN 46516-2501
(574) 293-6682
(574) 293-7947
Mailing address
336 W GARFIELD AVE, ELKHART, IN 46516-2501
(574) 293-6682
(574) 293-7947
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IN
Enumeration date
05/06/2010
Last updated
05/06/2010
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