Organization
MAKE SUPPORTIVE LIVING, LLC
Active
Parent organization
MAKE SUPPORTIVE LIVING, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAKE SUPPORTIVE LIVING, LLC
Authorized official
MS. TAMARA NICOLE MIXON HOME CARE PROVIDER (PRESIDENT/CEO)
(317) 724-8778
Entity
Organization
Contact information
Practice address
1639 N PARK AVE, INDIANAPOLIS, IN 46202-1720
(317) 724-8778
Mailing address
P.O BOX 88492, INDIANAPOLIS, IN 46208-0492
(317) 724-8778
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
IN
Other
Enumeration date
08/14/2008
Last updated
08/14/2008
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