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Organization

SUZY Q SERVICE CORORATION

Active
Other names
Suzy Q Cleaning Service LLC & Personal Service Agency
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SUZETT MOFFITT (PRESIDENT)
(317) 755-7664
Entity
Organization

Contact information

Practice address
2401 N TIBBS AVE, INDIANAPOLIS, IN 46222
(317) 955-7567
(317) 955-7567
Mailing address
2401 N TIBBS AVE, INDIANAPOLIS, IN 46222-2457
(317) 955-7567
(317) 955-7567

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
130130671
IN
372500000X
Chore Provider
18-013067-1
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18-013067-1
INDIANA STATE DEPARTMENT OF HEALTH/PERSONAL SERVICE AGENCY
IN
05
201172830A
IN
Enumeration date
07/12/2013
Last updated
08/28/2018
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