Provider Demographics
NPI:1083991038
Name:GIFTED HANDS PERSONAL CARE SERVICES
Entity Type:Organization
Organization Name:GIFTED HANDS PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ULIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-903-0997
Mailing Address - Street 1:800 W CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516-2332
Mailing Address - Country:US
Mailing Address - Phone:574-903-0997
Mailing Address - Fax:
Practice Address - Street 1:800 W CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46516-2332
Practice Address - Country:US
Practice Address - Phone:574-903-0997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based