Provider Demographics
NPI:1124602487
Name:HANDS OF GLORY HOMECARE LLC
Entity Type:Organization
Organization Name:HANDS OF GLORY HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-431-8553
Mailing Address - Street 1:2102 W COCO CT APT P5
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-7612
Mailing Address - Country:US
Mailing Address - Phone:813-431-8553
Mailing Address - Fax:
Practice Address - Street 1:2102 W COCO CT APT P5
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-7612
Practice Address - Country:US
Practice Address - Phone:813-431-8553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty