Provider Demographics
NPI:1689245979
Name:IMPRESSIVE HANDS HOMECARE LLC
Entity Type:Organization
Organization Name:IMPRESSIVE HANDS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAWANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-423-7366
Mailing Address - Street 1:1198 NEWVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-1739
Mailing Address - Country:US
Mailing Address - Phone:347-423-7366
Mailing Address - Fax:
Practice Address - Street 1:1198 NEWVILLE RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-1739
Practice Address - Country:US
Practice Address - Phone:347-423-7366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health