Provider Demographics
NPI:1235579616
Name:KELLY'S HELPING HANDS,INC
Entity Type:Organization
Organization Name:KELLY'S HELPING HANDS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:3524633000
Authorized Official - Phone:352-463-3000
Mailing Address - Street 1:PO BOX 484
Mailing Address - Street 2:
Mailing Address - City:OLD TOWN
Mailing Address - State:FL
Mailing Address - Zip Code:32680-0484
Mailing Address - Country:US
Mailing Address - Phone:352-463-3000
Mailing Address - Fax:352-463-3055
Practice Address - Street 1:16648 NW HWY 19
Practice Address - Street 2:
Practice Address - City:FANNING SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32693
Practice Address - Country:US
Practice Address - Phone:352-463-3000
Practice Address - Fax:352-463-3055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003597100Medicaid