Provider Demographics
NPI:1467687111
Name:GRANGEFORD HOLDINGS INC
Entity Type:Organization
Organization Name:GRANGEFORD HOLDINGS INC
Other - Org Name:ASSISTING HANDS FORT MYERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-337-4263
Mailing Address - Street 1:1850 BOY SCOUT DR
Mailing Address - Street 2:SUITE A103
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-2127
Mailing Address - Country:US
Mailing Address - Phone:239-337-4263
Mailing Address - Fax:239-247-5151
Practice Address - Street 1:1850 BOY SCOUT DR
Practice Address - Street 2:SUITE A103
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2127
Practice Address - Country:US
Practice Address - Phone:239-337-4263
Practice Address - Fax:239-247-5151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA#299992935251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL693524996OtherAPD
FL693345900OtherMEDICAID WAIVER
FL693524998OtherH & C BASED