Healthcare Provider Details

I. General information

NPI: 1225965809
Provider Name (Legal Business Name): GENTLE HAVEN HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 CALOOSA RIDGE AVE
BABSON PARK FL
33827-9725
US

IV. Provider business mailing address

PO BOX 94
LAKE WALES FL
33859-0094
US

V. Phone/Fax

Practice location:
  • Phone: 863-241-4378
  • Fax: 863-241-4378
Mailing address:
  • Phone: 863-241-4378
  • Fax: 863-241-4378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LOTTIE HAMILTON
Title or Position: CEO / MANAGER
Credential:
Phone: 863-241-4378