Provider Demographics
NPI:1598505000
Name:LUCILLES HOUSE OF COMPANION
Entity type:Organization
Organization Name:LUCILLES HOUSE OF COMPANION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-954-3337
Mailing Address - Street 1:11452 HIGH TIMBER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-6124
Mailing Address - Country:US
Mailing Address - Phone:317-954-3337
Mailing Address - Fax:
Practice Address - Street 1:11452 HIGH TIMBER DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-6124
Practice Address - Country:US
Practice Address - Phone:317-954-3337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health