Provider Demographics
NPI:1124305131
Name:NURSING AMERICA BACK 2 PERFECT LLC
Entity type:Organization
Organization Name:NURSING AMERICA BACK 2 PERFECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHOCHANTA
Authorized Official - Middle Name:BENITA
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:317-213-3780
Mailing Address - Street 1:5356 PELHAM WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46216-2214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-473-2963
Practice Address - Street 1:5356 PELHAM WAY
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46216-2214
Practice Address - Country:US
Practice Address - Phone:317-213-3780
Practice Address - Fax:888-473-2963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-05
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27046327A253Z00000X, 311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No253Z00000XAgenciesIn Home Supportive Care