Provider Demographics
NPI:1699595835
Name:GENTLE CARE HOMEHLEATH LLC
Entity type:Organization
Organization Name:GENTLE CARE HOMEHLEATH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-500-0540
Mailing Address - Street 1:2182 ALBERT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-5806
Mailing Address - Country:US
Mailing Address - Phone:614-500-0540
Mailing Address - Fax:
Practice Address - Street 1:2182 ALBERT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-5806
Practice Address - Country:US
Practice Address - Phone:614-500-0540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty