Healthcare Provider Details
I. General information
NPI: 1033716667
Provider Name (Legal Business Name): LENDING HANDS OF INSPIRATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2020
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 S VOLUSIA ST
ST AUGUSTINE FL
32084-0406
US
IV. Provider business mailing address
401 S VOLUSIA ST
ST AUGUSTINE FL
32084-0406
US
V. Phone/Fax
- Phone: 904-392-1058
- Fax:
- Phone: 904-392-1058
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372500000X |
| Taxonomy | Chore Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372600000X |
| Taxonomy | Adult Companion |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
STADASHA
D
ANDERSON
Title or Position: OWNER
Credential:
Phone: 904-392-1058