Healthcare Provider Details

I. General information

NPI: 1780258483
Provider Name (Legal Business Name): HANDS 2 HANDS SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2021
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3691 NW 155TH ST
REDDICK FL
32686-3462
US

IV. Provider business mailing address

3691 NW 155TH ST
REDDICK FL
32686-3462
US

V. Phone/Fax

Practice location:
  • Phone: 352-525-5066
  • Fax: 352-591-3153
Mailing address:
  • Phone: 352-525-5066
  • Fax: 352-591-3153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BEVERLY THOMAS
Title or Position: OWNER
Credential:
Phone: 352-525-5066