Provider Demographics
NPI:1114785391
Name:HEALING HANDS IV LLC
Entity Type:Organization
Organization Name:HEALING HANDS IV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCELLO
Authorized Official - Middle Name:
Authorized Official - Last Name:NICOLOSI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:941-276-2552
Mailing Address - Street 1:690 SHARON CIR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8348
Mailing Address - Country:US
Mailing Address - Phone:941-276-2552
Mailing Address - Fax:941-761-6959
Practice Address - Street 1:690 SHARON CIR
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8348
Practice Address - Country:US
Practice Address - Phone:941-276-2552
Practice Address - Fax:941-761-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No347C00000XTransportation ServicesPrivate Vehicle