Provider Demographics
NPI:1063029288
Name:GENTLE HANDS OF CARE,LLC
Entity type:Organization
Organization Name:GENTLE HANDS OF CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-999-1400
Mailing Address - Street 1:12450 BISCAYNE BLVD APT 620
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8628
Mailing Address - Country:US
Mailing Address - Phone:904-999-1400
Mailing Address - Fax:904-990-1449
Practice Address - Street 1:12450 BISCAYNE BLVD APT 620
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-8628
Practice Address - Country:US
Practice Address - Phone:904-999-1400
Practice Address - Fax:904-990-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care