Provider Demographics
NPI:1790155422
Name:HEALING HANDS PCA LLC
Entity Type:Organization
Organization Name:HEALING HANDS PCA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANLETTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NYANTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-218-8529
Mailing Address - Street 1:1014 TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19054-1002
Mailing Address - Country:US
Mailing Address - Phone:267-799-4714
Mailing Address - Fax:267-799-4716
Practice Address - Street 1:1014 TRENTON RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19054-1002
Practice Address - Country:US
Practice Address - Phone:267-799-4714
Practice Address - Fax:267-799-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA26903601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA26903601OtherHOMECARE AGENCY