Provider Demographics
NPI:1801556030
Name:GIFTED HANDS HOMECARE LLC AGENCY
Entity type:Organization
Organization Name:GIFTED HANDS HOMECARE LLC AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMOAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOGANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-419-0872
Mailing Address - Street 1:1323 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32433-1556
Mailing Address - Country:US
Mailing Address - Phone:850-419-0872
Mailing Address - Fax:
Practice Address - Street 1:1323 N 20TH ST
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32433-1556
Practice Address - Country:US
Practice Address - Phone:850-419-0872
Practice Address - Fax:850-331-1532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health