Provider Demographics
NPI:1982008645
Name:HEALING HANDS HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:HEALING HANDS HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AFMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MERICE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENDRIQUES-BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:860-890-3329
Mailing Address - Street 1:208 KING PHILIP DR
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1408
Mailing Address - Country:US
Mailing Address - Phone:860-890-3329
Mailing Address - Fax:
Practice Address - Street 1:208 KING PHILIP DR
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1408
Practice Address - Country:US
Practice Address - Phone:860-233-6771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE47254251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTE47254OtherRN