Provider Demographics
NPI:1497186290
Name:GOOD HANDS PROVIDER SERVICES LLC
Entity Type:Organization
Organization Name:GOOD HANDS PROVIDER SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:HAJA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CONTEH
Authorized Official - Suffix:
Authorized Official - Credentials:DIRECTOR
Authorized Official - Phone:614-929-1784
Mailing Address - Street 1:3978 FOREST EDGE DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1018
Mailing Address - Country:US
Mailing Address - Phone:614-929-1784
Mailing Address - Fax:
Practice Address - Street 1:3978 FOREST EDGE DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1018
Practice Address - Country:US
Practice Address - Phone:614-929-1784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 119583253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care