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Organization

RELIANT@HOME LTD

Active
Parent organization
PDS MANAGEMENT CORP
Other names
Reliant At Home LTD
Organization subpart
Yes

Provider details

NPI number
Legal business name
PDS MANAGEMENT CORP
Authorized official
MRS. SHARI L PENTICUFF RN, BSN (ADMINISTRATOR/DIRECTOR)
(317) 674-8453
Entity
Organization

Contact information

Practice address
341 LOGAN ST STE L110, NOBLESVILLE, IN 46060-1610
(317) 674-8453
(317) 674-8703
Mailing address
9301 S POINTE LASALLES DR, BLOOMINGTON, IN 47401-9011
(855) 557-6669
(855) 557-3291

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
11-012546-1
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11-012546-1
INDIANA STATE DEPARTMENT OF HEALTH LICENSE
IN
Enumeration date
03/11/2011
Last updated
07/21/2022
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