Provider Demographics
NPI:1699201525
Name:GENTL CARE ASSISTANCE I
Entity Type:Organization
Organization Name:GENTL CARE ASSISTANCE I
Other - Org Name:QUINNECA HARRIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUINNECA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-822-9275
Mailing Address - Street 1:5901 NW 17TH PL APT 105
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6976
Mailing Address - Country:US
Mailing Address - Phone:954-822-9275
Mailing Address - Fax:
Practice Address - Street 1:5901 NW 17TH PL APT 105
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-6976
Practice Address - Country:US
Practice Address - Phone:954-822-9275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health