Organization
VIA QUEST HOME HEALTH OF INDIANA, LLC
Active
Other names
Mulberry Community Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD JOHNSON (PRESIDENT)
(614) 339-0820
Entity
Organization
Contact information
Practice address
5 N 10TH ST, LAFAYETTE, IN 47901-1595
(765) 237-0086
(765) 296-2226
Mailing address
525 METRO PLACE NORTH, STE 300, DUBLIN, OH 43017
(614) 339-0814
(614) 339-1814
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
010480
IN
251E00000X
Home Health Agency
050104801
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200392450A
WAIVER
IN
Enumeration date
06/13/2006
Last updated
05/18/2016
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