Organization
A SOURCE OF LIFE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY BULLOCK (OWNER)
(317) 490-5526
Entity
Organization
Contact information
Practice address
1111 E 54TH ST STE 211, INDIANAPOLIS, IN 46220-3581
(317) 490-5526
Mailing address
1111 E 54TH ST STE 211, INDIANAPOLIS, IN 46220-3581
(317) 490-5526
(317) 682-1942
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
03/19/2025
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