Provider Demographics
NPI:1043547193
Name:H.A.N.D.S.
Entity Type:Organization
Organization Name:H.A.N.D.S.
Other - Org Name:HELPING AND NURTURING DIVINE SISTERS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAVONICA
Authorized Official - Middle Name:DIONNE
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-255-5576
Mailing Address - Street 1:322 CRAIG ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-2848
Mailing Address - Country:US
Mailing Address - Phone:336-255-5576
Mailing Address - Fax:
Practice Address - Street 1:1910 MCKNIGHT MILL RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-3908
Practice Address - Country:US
Practice Address - Phone:336-621-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-041-862322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6604338Medicaid