Healthcare Provider Details

I. General information

NPI: 1548921273
Provider Name (Legal Business Name): GOD'S HELPING HANDS PSA, NWI. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2022
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 JENNINGS ST
MERRILLVILLE IN
46410-5121
US

IV. Provider business mailing address

7702 JENNINGS ST
MERRILLVILLE IN
46410-5121
US

V. Phone/Fax

Practice location:
  • Phone: 219-208-7702
  • Fax:
Mailing address:
  • Phone: 219-208-7702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. JACQULYN F MARCUS-GEORGE
Title or Position: CO-OWNER
Credential:
Phone: 219-644-5993