Provider Demographics
NPI:1053108050
Name:GENTLE CARE HEALTH SERVICES LLC
Entity type:Organization
Organization Name:GENTLE CARE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:D
Authorized Official - Last Name:IVUMBI
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, PHARMD
Authorized Official - Phone:703-850-3491
Mailing Address - Street 1:5750 DOW AVE APT 217
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-4069
Mailing Address - Country:US
Mailing Address - Phone:703-850-3491
Mailing Address - Fax:
Practice Address - Street 1:5750 DOW AVE APT 217
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-4069
Practice Address - Country:US
Practice Address - Phone:703-850-3491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances