Organization
PEAK HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN M OGLESBY ODOM RN (ADMINISTRATOR)
(219) 472-9820
Entity
Organization
Contact information
Practice address
8684 CONNECTICUT ST, SUITE A2, MERRILLVILLE, IN 46410-5580
(219) 472-9820
(219) 472-9821
Mailing address
8684 CONNECTICUT ST, SUITE A2, MERRILLVILLE, IN 46410-5580
(219) 472-9820
(219) 472-9821
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
120128881
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120128881
STATE LICENSURE
IN
Enumeration date
06/06/2012
Last updated
03/25/2013
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