| NPI | 1942128376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA LATELY Owner/Operator 317-354-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2026-07-06 |
| Last Update Date | 2026-07-06 |