Provider Demographics
NPI:1649049180
Name:GENTLE HANDS SENIOR CARE LLC
Entity type:Organization
Organization Name:GENTLE HANDS SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ALMIRA
Authorized Official - Last Name:GENTLE
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:562-612-8163
Mailing Address - Street 1:14379 CHUMASH PL
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-6755
Mailing Address - Country:US
Mailing Address - Phone:562-612-8163
Mailing Address - Fax:
Practice Address - Street 1:14379 CHUMASH PL
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-6755
Practice Address - Country:US
Practice Address - Phone:562-612-8163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care