Provider Demographics
NPI:1710295712
Name:FORTUNATE HANDS HEALTH CARE SERVICES, LLC
Entity Type:Organization
Organization Name:FORTUNATE HANDS HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROTONGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-617-6885
Mailing Address - Street 1:504 MCCAIN DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-7846
Mailing Address - Country:US
Mailing Address - Phone:903-617-6885
Mailing Address - Fax:
Practice Address - Street 1:504 MCCAIN DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-7846
Practice Address - Country:US
Practice Address - Phone:903-617-6885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health