Provider Demographics
NPI:1467258749
Name:PATTYSGIRLHEAVENLYHANDS HOMECARE
Entity type:Organization
Organization Name:PATTYSGIRLHEAVENLYHANDS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHEEKERIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARGRAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-583-0749
Mailing Address - Street 1:861443 WORTHINGTON DR
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-6453
Mailing Address - Country:US
Mailing Address - Phone:904-583-0749
Mailing Address - Fax:
Practice Address - Street 1:861443 WORTHINGTON DR
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-6453
Practice Address - Country:US
Practice Address - Phone:904-583-0749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty