Organization
BLACK PEARL LIFE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNITHA BARNES (OWNER/MANAGER)
(219) 757-1481
Entity
Organization
Contact information
Practice address
4237 E 10TH AVE, GARY, IN 46403-3529
(219) 614-9428
Mailing address
5534 SAINT JOE RD, FORT WAYNE, IN 46835-3328
(219) 614-9428
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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