Individual
EUGENIA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
51541 BITTERSWEET RD, GRANGER, IN 46530-4987
(574) 400-7270
(574) 222-2658
Mailing address
51541 BITTERSWEET RD, GRANGER, IN 46530-4987
(574) 400-7270
(574) 222-2658
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
IN
Enumeration date
07/15/2021
Last updated
04/09/2024
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