Provider Demographics
NPI:1316711104
Name:STAY AT HOME HEALTH, LLC
Entity type:Organization
Organization Name:STAY AT HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KITRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDER
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:765-993-4040
Mailing Address - Street 1:9247 N MERIDIAN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1824
Mailing Address - Country:US
Mailing Address - Phone:765-993-4040
Mailing Address - Fax:317-559-4774
Practice Address - Street 1:9247 N MERIDIAN ST STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1824
Practice Address - Country:US
Practice Address - Phone:765-993-4040
Practice Address - Fax:317-559-4774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health