Provider Demographics
NPI:1043629884
Name:HEALING HANDS PRIVATE CARE ,LLC
Entity Type:Organization
Organization Name:HEALING HANDS PRIVATE CARE ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:SLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-387-9409
Mailing Address - Street 1:4440 IDLEWOOD PARK
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6247
Mailing Address - Country:US
Mailing Address - Phone:678-559-8378
Mailing Address - Fax:
Practice Address - Street 1:2100 PARKLAKE DR NE # C-5
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2824
Practice Address - Country:US
Practice Address - Phone:678-387-9409
Practice Address - Fax:470-401-2557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health