Provider Demographics
NPI:1093347205
Name:GENTLE SHEPHERD CARE
Entity Type:Organization
Organization Name:GENTLE SHEPHERD CARE
Other - Org Name:NURSING SHEPHERD HOME HEALTH CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-340-6546
Mailing Address - Street 1:8604 CLIFF CAMERON DR STE 144
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-8512
Mailing Address - Country:US
Mailing Address - Phone:704-209-5040
Mailing Address - Fax:
Practice Address - Street 1:1914 J N PEASE PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4504
Practice Address - Country:US
Practice Address - Phone:704-209-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care