Organization
ALTRA HOMECARE GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS WYNNE (PRESIDENT)
(317) 672-6155
Entity
Organization
Contact information
Practice address
7400 N SHADELAND AVE STE 258, INDIANAPOLIS, IN 46250-2886
(317) 672-6155
Mailing address
7400 N SHADELAND AVE STE 258, INDIANAPOLIS, IN 46250-2886
(317) 672-6155
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300052063
—
IN
Enumeration date
09/14/2021
Last updated
09/14/2021
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