Provider Demographics
NPI:1972807915
Name:GENTLE HANDS
Entity Type:Organization
Organization Name:GENTLE HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-291-0489
Mailing Address - Street 1:1615 WASHINGTON ST E
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-5561
Mailing Address - Country:US
Mailing Address - Phone:252-991-2838
Mailing Address - Fax:252-991-2838
Practice Address - Street 1:1615 WASHINGTON ST E
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-5561
Practice Address - Country:US
Practice Address - Phone:252-991-2838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-098-155320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities