Individual
KHALILAH ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2302 E MICHIGAN BLVD, MICHIGAN CITY, IN 46360-5372
(219) 229-4421
Mailing address
2302 E MICHIGAN BLVD, MICHIGAN CITY, IN 46360-5372
(219) 229-4421
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
25-018545-1
IN
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
25018545
IN
Other
Enumeration date
01/21/2025
Last updated
10/21/2025
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