Healthcare Provider Details

I. General information

NPI: 1346553096
Provider Name (Legal Business Name): MCCOY'S HELPING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2010
Last Update Date: 07/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 LORNA DR
GLEN ELLEN CA
95442-9647
US

IV. Provider business mailing address

PO BOX 465
SONOMA CA
95476-0465
US

V. Phone/Fax

Practice location:
  • Phone: 707-287-3908
  • Fax:
Mailing address:
  • Phone: 707-287-3908
  • Fax: 707-933-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMI COTTER
Title or Position: ADMINISTRATIOR
Credential:
Phone: 707-287-3908