Healthcare Provider Details

I. General information

NPI: 1174457659
Provider Name (Legal Business Name): TALAES LOVING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 FOURTH ST
GRETNA FL
32332-2167
US

IV. Provider business mailing address

265 FOURTH ST
GRETNA FL
32332-2167
US

V. Phone/Fax

Practice location:
  • Phone: 850-755-6904
  • Fax:
Mailing address:
  • Phone: 850-755-6904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: YAMIAYA TALAE WILLIAMS
Title or Position: OWNER
Credential:
Phone: 850-755-6904