Provider Demographics
NPI:1427889492
Name:GREAT HANDZ REHABILITATION, LLC
Entity type:Organization
Organization Name:GREAT HANDZ REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-577-2112
Mailing Address - Street 1:1010 PROGRESS ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-4880
Mailing Address - Country:US
Mailing Address - Phone:337-577-2112
Mailing Address - Fax:
Practice Address - Street 1:1010 PROGRESS ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-4880
Practice Address - Country:US
Practice Address - Phone:337-577-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility