Provider Demographics
NPI:1013573195
Name:HALLOW HANDS HOME CARE LTD
Entity Type:Organization
Organization Name:HALLOW HANDS HOME CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-551-5085
Mailing Address - Street 1:10954 FREE FLOW PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6165
Mailing Address - Country:US
Mailing Address - Phone:702-551-5085
Mailing Address - Fax:
Practice Address - Street 1:3305 SPRING MOUNTAIN RD STE 41
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8622
Practice Address - Country:US
Practice Address - Phone:702-551-5085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV20191365892OtherNEVADA BUSINESS LICENSE