Organization
111HOME HEALTH CARE AGENCY
Active
Other names
111Home Personal Care Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAVERN I SUGGS CEO (CEO)
(574) 350-9831
Entity
Organization
Contact information
Practice address
336 W GARFIELD AVE, ELKHART, IN 46516-2501
(574) 350-9831
(574) 293-7947
Mailing address
336 W GARFIELD AVE, ELKHART, IN 46516-2501
(574) 350-9831
(574) 293-7947
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
11-012725-1
IN
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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