Healthcare Provider Details

I. General information

NPI: 1154048031
Provider Name (Legal Business Name): IN HER HANDS GROUP HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37312 MAIN AVE
DADE CITY FL
33523-3026
US

IV. Provider business mailing address

37312 MAIN AVE
DADE CITY FL
33523-3026
US

V. Phone/Fax

Practice location:
  • Phone: 813-713-5538
  • Fax:
Mailing address:
  • Phone: 813-713-5538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: K'BRIA CHARLOTIN
Title or Position: EXECUTIVE DIRECTOR/OWNER
Credential: LCSW
Phone: 404-337-7068