| NPI | 1790566966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERITAGE EWAOLUWA OGUNMOLA Owner 317-607-5447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 171W00000X Contractor |
| 251E00000X Home Health | |
| 251J00000X Nursing Care | |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2024-10-29 |