Provider Demographics
NPI:1588543193
Name:GENTLE SPIRITS HOMECARE LLC
Entity type:Organization
Organization Name:GENTLE SPIRITS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAKVALA
Authorized Official - Middle Name:
Authorized Official - Last Name:NADIRASHVILI
Authorized Official - Suffix:
Authorized Official - Credentials:AMBR
Authorized Official - Phone:305-522-4216
Mailing Address - Street 1:4000 HOLLYWOOD BLVD
Mailing Address - Street 2:555-S
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6853
Mailing Address - Country:US
Mailing Address - Phone:212-203-6067
Mailing Address - Fax:212-203-6067
Practice Address - Street 1:4000 HOLLYWOOD BLVD
Practice Address - Street 2:555-S
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6853
Practice Address - Country:US
Practice Address - Phone:212-203-6067
Practice Address - Fax:212-203-6067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty