Healthcare Provider Details

I. General information

NPI: 1013784693
Provider Name (Legal Business Name): GERIHANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 AMMER RIDGE CT UNIT 302
GLENVIEW IL
60025-1864
US

IV. Provider business mailing address

2460 DUNDEE RD UNIT 413
NORTHBROOK IL
60065-7915
US

V. Phone/Fax

Practice location:
  • Phone: 219-242-2351
  • Fax:
Mailing address:
  • Phone: 219-242-2351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE C MUMBA
Title or Position: PARTNER/COO
Credential:
Phone: 678-674-7799