Provider Demographics
NPI:1841422284
Name:HEALING HANDS SUPPORT SERVICES
Entity Type:Organization
Organization Name:HEALING HANDS SUPPORT SERVICES
Other - Org Name:HEALING HANDS HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENYETTA
Authorized Official - Middle Name:BANQUA
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-849-8774
Mailing Address - Street 1:11709 FRUEHAUF DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-6507
Mailing Address - Country:US
Mailing Address - Phone:404-849-8774
Mailing Address - Fax:
Practice Address - Street 1:11709 FRUEHAUF DR
Practice Address - Street 2:SUITE 225
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6507
Practice Address - Country:US
Practice Address - Phone:404-849-8774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-19
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health