Provider Demographics
NPI:1992536254
Name:GOOD SAMARITAN HOME CARE LLC
Entity type:Organization
Organization Name:GOOD SAMARITAN HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:463-710-5465
Mailing Address - Street 1:8250 BASH ST # C7
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1938
Mailing Address - Country:US
Mailing Address - Phone:463-710-5465
Mailing Address - Fax:
Practice Address - Street 1:8250 BASH ST # C7
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1938
Practice Address - Country:US
Practice Address - Phone:463-710-5465
Practice Address - Fax:317-342-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-09
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No253Z00000XAgenciesIn Home Supportive Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child