Organization
HOME CARE SUPPORT, INC
Active
Other names
Home Care Assistance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF ALISCH SR. BSW, CSA (CEO)
(574) 289-4444
Entity
Organization
Contact information
Practice address
1635 N IRONWOOD DR STE 1, SOUTH BEND, IN 46635-1847
(574) 289-4444
(574) 247-1564
Mailing address
1635 N IRONWOOD DR STE 1, SOUTH BEND, IN 46635-1847
(574) 289-4444
(574) 247-1564
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
12-012237-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200974790-A
MEDICADE LEGACY PROVIDER NUMBER
IN
Enumeration date
09/23/2013
Last updated
09/23/2013
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