Provider Demographics
NPI:1245400241
Name:GENTLE SPIRIT HOME CARE
Entity Type:Organization
Organization Name:GENTLE SPIRIT HOME CARE
Other - Org Name:IN HOME CARE AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BENEDICT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-992-8166
Mailing Address - Street 1:69295 MCCALLUM WAY
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-2990
Mailing Address - Country:US
Mailing Address - Phone:760-992-8166
Mailing Address - Fax:
Practice Address - Street 1:69295 MCCALLUM WAY
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-2990
Practice Address - Country:US
Practice Address - Phone:760-992-8166
Practice Address - Fax:760-992-8166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA009827305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service