Provider Demographics
NPI:1063303048
Name:SONG BIRDS PERSONAL CARE SERVICES,LLC
Entity type:Organization
Organization Name:SONG BIRDS PERSONAL CARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-724-4964
Mailing Address - Street 1:6806 W PRIMROSE DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-8920
Mailing Address - Country:US
Mailing Address - Phone:317-724-4964
Mailing Address - Fax:317-724-4964
Practice Address - Street 1:8949 E WASHINGTON ST STE C3
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-6829
Practice Address - Country:US
Practice Address - Phone:131-772-4496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care