Provider Demographics
NPI:1902621279
Name:GANT FAMILY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:GANT FAMILY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRITTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GANT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:317-448-0271
Mailing Address - Street 1:3418 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-4402
Mailing Address - Country:US
Mailing Address - Phone:317-448-0271
Mailing Address - Fax:317-602-8124
Practice Address - Street 1:3418 E 20TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-4402
Practice Address - Country:US
Practice Address - Phone:317-448-0271
Practice Address - Fax:317-602-8124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health