MEDICARE: GOD'S GIFT PROFESSIONAL CARE SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	10506	LA
2	251E00000X	Home Health Agency	10503	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982727699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOD'S GIFT PROFESSIONAL CARE SERVICE

Provider Business Mailing Address
First Line	:	2620 CENTENARY BLVD
Second Line	:	BLDG 1 SUITE 104
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-3356
Country	:	US
Telephone Number	:	318-629-5391
Fax Number	:	318-629-5392

Provider Business Practice Location Address
First Line	:	2620 CENTENARY BLVD
Second Line	:	BLDG 1 SUITE 104
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-3356
Country	:	US
Telephone Number	:	318-629-5391
Fax Number	:	318-629-5392

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. SCHAWANDA ALLEN COLEMAN
Credential	:
Telephone Number	:	318-629-5391

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	08/22/2020

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Directions to “GOD'S GIFT PROFESSIONAL CARE SERVICE ” Practice Location

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