Healthcare Provider Details

I. General information

NPI: 1013617406
Provider Name (Legal Business Name): ETIENNES HELPING HANDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 GLENWOOD RD
DELAND FL
32720-2109
US

IV. Provider business mailing address

1430 GLENWOOD RD
DELAND FL
32720-2109
US

V. Phone/Fax

Practice location:
  • Phone: 561-541-4155
  • Fax:
Mailing address:
  • Phone: 561-541-4155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KEMBERLY ANTOINE
Title or Position: CEO
Credential:
Phone: 561-541-4155