Provider Demographics
NPI:1801947049
Name:GENTLE HEARTS
Entity type:Organization
Organization Name:GENTLE HEARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TIKINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-717-0560
Mailing Address - Street 1:6860 TIMBERCROFT LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-5389
Mailing Address - Country:US
Mailing Address - Phone:910-717-0560
Mailing Address - Fax:910-717-0560
Practice Address - Street 1:6860 TIMBERCROFT LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-5389
Practice Address - Country:US
Practice Address - Phone:910-717-0560
Practice Address - Fax:910-717-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health