Provider Demographics
NPI:1629512819
Name:GRANDMA'S HANDS HOME HEALTH LLC
Entity Type:Organization
Organization Name:GRANDMA'S HANDS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOZZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-395-5935
Mailing Address - Street 1:119 CHURCH ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:FERGUSON
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2442
Mailing Address - Country:US
Mailing Address - Phone:314-395-5935
Mailing Address - Fax:
Practice Address - Street 1:119 CHURCH ST
Practice Address - Street 2:SUITE 121
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135-2442
Practice Address - Country:US
Practice Address - Phone:314-395-5935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC001437513251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health