Provider Demographics
NPI:1366969636
Name:K&P GENTLE HNADS HOMECARE
Entity type:Organization
Organization Name:K&P GENTLE HNADS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MECHELLE
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-656-6318
Mailing Address - Street 1:772 POINTE SOUTH PKWY APT 501
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-4398
Mailing Address - Country:US
Mailing Address - Phone:678-656-6318
Mailing Address - Fax:678-829-3364
Practice Address - Street 1:772 POINTE SOUTH PKWY
Practice Address - Street 2:APT. 501
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238
Practice Address - Country:US
Practice Address - Phone:678-656-6318
Practice Address - Fax:678-829-3364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health