Provider Demographics
NPI:1982019816
Name:TAKITA S. HAYES DBA TAKITA'S HELPING HANDS
Entity Type:Organization
Organization Name:TAKITA S. HAYES DBA TAKITA'S HELPING HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAKITA
Authorized Official - Middle Name:SHONTA
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-504-8954
Mailing Address - Street 1:5024 GRASSY KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-6211
Mailing Address - Country:US
Mailing Address - Phone:352-504-8964
Mailing Address - Fax:
Practice Address - Street 1:5024 GRASSY KNOLL DR
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-6211
Practice Address - Country:US
Practice Address - Phone:352-504-8964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL009976600251E00000X
251E00000X, 253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102962400Medicaid