Provider Demographics
NPI:1689381220
Name:GIFTED HANDS HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:GIFTED HANDS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAKIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:863-588-5879
Mailing Address - Street 1:2214 MANGO AVE
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-4532
Mailing Address - Country:US
Mailing Address - Phone:863-588-5879
Mailing Address - Fax:
Practice Address - Street 1:2214 MANGO AVE
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-4532
Practice Address - Country:US
Practice Address - Phone:863-588-5879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF540792906470OtherDRIVERS LICENSE