Provider Demographics
NPI:1821458191
Name:GIFTED HANDS PERSONAL CARE HOMES
Entity Type:Organization
Organization Name:GIFTED HANDS PERSONAL CARE HOMES
Other - Org Name:GIFTED HANDS HOME CARE NURSING AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:678-281-4542
Mailing Address - Street 1:PO BOX 392704
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-0046
Mailing Address - Country:US
Mailing Address - Phone:678-242-9026
Mailing Address - Fax:
Practice Address - Street 1:2850 IVY BROOK LN
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-7912
Practice Address - Country:US
Practice Address - Phone:678-242-9026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-01
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health