Provider Demographics
NPI:1811553746
Name:PERFECT GENTLE HANDS HOMECARE INC
Entity Type:Organization
Organization Name:PERFECT GENTLE HANDS HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:HHA
Authorized Official - Phone:347-809-4407
Mailing Address - Street 1:9211 172ND ST FL 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-1218
Mailing Address - Country:US
Mailing Address - Phone:347-809-4407
Mailing Address - Fax:347-960-7169
Practice Address - Street 1:9211 172ND ST FL 2
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11433-1218
Practice Address - Country:US
Practice Address - Phone:347-809-4407
Practice Address - Fax:347-960-7169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2347L001Medicaid