Provider Demographics
NPI:1962881276
Name:RICHARDSON ANOINTING HANDS
Entity type:Organization
Organization Name:RICHARDSON ANOINTING HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY
Authorized Official - Prefix:
Authorized Official - First Name:BERNESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-398-0451
Mailing Address - Street 1:708 EAST PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810
Mailing Address - Country:US
Mailing Address - Phone:863-398-0451
Mailing Address - Fax:863-603-8896
Practice Address - Street 1:708EAST PONDEROSA DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810
Practice Address - Country:US
Practice Address - Phone:863-398-0451
Practice Address - Fax:863-603-8896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
FL014133000320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities