Provider Demographics
NPI:1013635218
Name:GIFTED HANDS HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:GIFTED HANDS HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLATUNDE
Authorized Official - Middle Name:O
Authorized Official - Last Name:FATINIKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-575-3110
Mailing Address - Street 1:20144 PROVIDENCE LN
Mailing Address - Street 2:
Mailing Address - City:LYNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60411-1082
Mailing Address - Country:US
Mailing Address - Phone:708-898-1750
Mailing Address - Fax:
Practice Address - Street 1:20144 PROVIDENCE LN
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60411-1082
Practice Address - Country:US
Practice Address - Phone:708-898-1750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care