Provider Demographics
NPI:1417707803
Name:GENTLE HANDS HOME CARE
Entity Type:Organization
Organization Name:GENTLE HANDS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEDRA
Authorized Official - Middle Name:LAVON
Authorized Official - Last Name:HARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-571-1429
Mailing Address - Street 1:9063 REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:BLACKVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29817-4649
Mailing Address - Country:US
Mailing Address - Phone:803-686-2169
Mailing Address - Fax:803-219-7005
Practice Address - Street 1:19340 SOLOMON BLATT AVE N
Practice Address - Street 2:
Practice Address - City:BLACKVILLE
Practice Address - State:SC
Practice Address - Zip Code:29817-2304
Practice Address - Country:US
Practice Address - Phone:803-571-1429
Practice Address - Fax:803-219-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care