Provider Demographics
NPI:1508535584
Name:CARING HANDS WITH LOVE BY PEACHES
Entity Type:Organization
Organization Name:CARING HANDS WITH LOVE BY PEACHES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROVENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHRIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-699-2502
Mailing Address - Street 1:401 N FOSTER ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-4554
Mailing Address - Country:US
Mailing Address - Phone:334-350-7478
Mailing Address - Fax:
Practice Address - Street 1:401 N FOSTER ST STE 3
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-4554
Practice Address - Country:US
Practice Address - Phone:334-350-7478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No347C00000XTransportation ServicesPrivate Vehicle