Provider Demographics
NPI:1417768581
Name:EXCEPTIONAL HOME CARE LLC
Entity type:Organization
Organization Name:EXCEPTIONAL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLYN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:TUTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-289-3640
Mailing Address - Street 1:4476 WESTBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-2554
Mailing Address - Country:US
Mailing Address - Phone:317-289-3640
Mailing Address - Fax:
Practice Address - Street 1:4476 WESTBOURNE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2554
Practice Address - Country:US
Practice Address - Phone:317-289-3640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health