Healthcare Provider Details

I. General information

NPI: 1336405257
Provider Name (Legal Business Name): HEALING HANDS PERSONAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 E ST
MACON GA
31206-8338
US

IV. Provider business mailing address

870 E ST
MACON GA
31206-8338
US

V. Phone/Fax

Practice location:
  • Phone: 404-493-0867
  • Fax: 478-254-8837
Mailing address:
  • Phone: 404-493-0867
  • Fax: 478-254-8837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. TIMISHEA TILLMAN
Title or Position: OWNER
Credential:
Phone: 404-493-0867