Healthcare Provider Details

I. General information

NPI: 1003126624
Provider Name (Legal Business Name): HEALING HANDS SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2010
Last Update Date: 10/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 NEWTONS CREST CIR
SNELLVILLE GA
30078-6939
US

IV. Provider business mailing address

3503 NEWTONS CREST CIR
SNELLVILLE GA
30078-6939
US

V. Phone/Fax

Practice location:
  • Phone: 678-517-7775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number126444
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License NumberRN126444
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number126444
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number126444
License Number StateGA

VIII. Authorized Official

Name: ELIZABETH SMITH
Title or Position: DIRECTOR
Credential:
Phone: 678-517-7775