Provider Demographics
NPI:1538038997
Name:GENTLE CARE SUPPORT SERVICES
Entity type:Organization
Organization Name:GENTLE CARE SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:734-363-7073
Mailing Address - Street 1:7428 HARTEL ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-5556
Mailing Address - Country:US
Mailing Address - Phone:313-516-0830
Mailing Address - Fax:
Practice Address - Street 1:4800 GRAY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215-2043
Practice Address - Country:US
Practice Address - Phone:313-516-0830
Practice Address - Fax:313-499-8423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty