Provider Demographics
NPI:1669721726
Name:KLIPSCH SENIOR CARE LLC
Entity type:Organization
Organization Name:KLIPSCH SENIOR CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:GUNTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-471-0050
Mailing Address - Street 1:223 NW 2ND ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47708-1207
Mailing Address - Country:US
Mailing Address - Phone:812-471-0050
Mailing Address - Fax:812-471-2822
Practice Address - Street 1:223 NW 2ND ST
Practice Address - Street 2:SUITE 310
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47708-1207
Practice Address - Country:US
Practice Address - Phone:812-471-0050
Practice Address - Fax:812-471-2822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120118361253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care