Provider Demographics
NPI:1295911956
Name:GENTLE HEARTS CARE
Entity type:Organization
Organization Name:GENTLE HEARTS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIKINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-322-1470
Mailing Address - Street 1:10151 DEERWOOD PARK BLVD
Mailing Address - Street 2:BUILDING E SUITE 250
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0566
Mailing Address - Country:US
Mailing Address - Phone:904-371-3088
Mailing Address - Fax:
Practice Address - Street 1:10151 DEERWOOD PARK BLVD
Practice Address - Street 2:BUILDING E SUITE 250
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-0566
Practice Address - Country:US
Practice Address - Phone:904-371-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health