Organization
MAMA ANNIE'S HOME CARE LLC
Active
Other names
Mama Annies Home Care LLC, MAMA ANNIE'S HOME CARE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TALISHA T WILSON (OWNER)
(317) 657-9116
Entity
Organization
Contact information
Practice address
9165 OTIS AVE STE 110, INDIANAPOLIS, IN 46216-2307
(317) 657-9116
(317) 333-8027
Mailing address
9165 OTIS AVE STE 110, INDIANAPOLIS, IN 46216-2307
(317) 657-9116
(317) 333-8027
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300039776
—
IN
Enumeration date
11/15/2022
Last updated
12/01/2022
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