Provider Demographics
NPI:1538854682
Name:RAW HOME CARE SERVICES LLC.
Entity type:Organization
Organization Name:RAW HOME CARE SERVICES LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RANADA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMS-EDMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:317-550-1044
Mailing Address - Street 1:5645 E RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46203-4967
Mailing Address - Country:US
Mailing Address - Phone:317-550-1044
Mailing Address - Fax:317-550-0801
Practice Address - Street 1:5645 E RAYMOND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46203-4967
Practice Address - Country:US
Practice Address - Phone:317-550-1044
Practice Address - Fax:317-550-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No374U00000XNursing Service Related ProvidersHome Health Aide
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No163WC0400XNursing Service ProvidersRegistered NurseCase Management