Provider Demographics
NPI:1780643320
Name:HEALING HANDS GROUP HOMES INC.
Entity Type:Organization
Organization Name:HEALING HANDS GROUP HOMES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNER
Authorized Official - Middle Name:
Authorized Official - Last Name:DUCHEINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-340-7464
Mailing Address - Street 1:973 SE BROWNING AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-3937
Mailing Address - Country:US
Mailing Address - Phone:772-340-7464
Mailing Address - Fax:772-785-7108
Practice Address - Street 1:973 SE BROWNING AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-3937
Practice Address - Country:US
Practice Address - Phone:772-340-7464
Practice Address - Fax:772-785-7108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL151076320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities