Provider Demographics
NPI:1750091013
Name:BIDETS CARE LLC
Entity type:Organization
Organization Name:BIDETS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUBUNMI
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:RAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-985-6044
Mailing Address - Street 1:4215 W 86TH ST STE F
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1742
Mailing Address - Country:US
Mailing Address - Phone:463-206-2806
Mailing Address - Fax:
Practice Address - Street 1:4215 W 86TH ST STE F
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1742
Practice Address - Country:US
Practice Address - Phone:463-206-2806
Practice Address - Fax:463-206-2825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300053782Medicaid
IN300066489Medicaid