Provider Demographics
NPI:1649689043
Name:HANDS LLC OF ROWAN
Entity type:Organization
Organization Name:HANDS LLC OF ROWAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PORTER
Authorized Official - Middle Name:DAIS
Authorized Official - Last Name:MCRAVION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-310-9552
Mailing Address - Street 1:818 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-3410
Mailing Address - Country:US
Mailing Address - Phone:704-310-9552
Mailing Address - Fax:
Practice Address - Street 1:919 RICHARD ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3619
Practice Address - Country:US
Practice Address - Phone:704-310-9552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities