Provider Demographics
NPI:1760193098
Name:GENTLE HAND GROUP HOME
Entity Type:Organization
Organization Name:GENTLE HAND GROUP HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SAFFIATU
Authorized Official - Middle Name:
Authorized Official - Last Name:JANNEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-919-2718
Mailing Address - Street 1:25 WINDING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-3912
Mailing Address - Country:US
Mailing Address - Phone:540-919-2718
Mailing Address - Fax:
Practice Address - Street 1:18091 COOLIDGE LN
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:VA
Practice Address - Zip Code:22427-9340
Practice Address - Country:US
Practice Address - Phone:540-919-2718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health