Provider Demographics
NPI:1629679170
Name:GENTLEMIND HEALTH SERVICES
Entity Type:Organization
Organization Name:GENTLEMIND HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-416-5241
Mailing Address - Street 1:3635 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-5539
Mailing Address - Country:US
Mailing Address - Phone:260-271-9533
Mailing Address - Fax:260-239-6001
Practice Address - Street 1:3635 LAKE AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5539
Practice Address - Country:US
Practice Address - Phone:610-416-5241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health