Provider Demographics
NPI:1811616238
Name:GIFTED HANDS 5 LLC
Entity type:Organization
Organization Name:GIFTED HANDS 5 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-257-1587
Mailing Address - Street 1:4515 CAMDEN CT
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-1146
Mailing Address - Country:US
Mailing Address - Phone:708-257-1587
Mailing Address - Fax:708-794-3251
Practice Address - Street 1:4515 CAMDEN CT
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1146
Practice Address - Country:US
Practice Address - Phone:708-257-1587
Practice Address - Fax:708-794-3251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities