Provider Demographics
NPI:1326586744
Name:HAND-N-HAND PCH INC.
Entity Type:Organization
Organization Name:HAND-N-HAND PCH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-873-1968
Mailing Address - Street 1:125 JANETTE LN
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31788-7837
Mailing Address - Country:US
Mailing Address - Phone:229-873-1968
Mailing Address - Fax:229-324-2057
Practice Address - Street 1:125 JANETTE LN
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31788-7837
Practice Address - Country:US
Practice Address - Phone:229-873-1968
Practice Address - Fax:229-324-2057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACLA002111315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA225233062AMedicaid