Healthcare Provider Details

I. General information

NPI: 1790197515
Provider Name (Legal Business Name): GENTLE HEARTS HOME CARE, LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2841 GREENSBURG RD
BUFFALO KY
42716-8116
US

IV. Provider business mailing address

2841 GREENSBURG RD
BUFFALO KY
42716-8116
US

V. Phone/Fax

Practice location:
  • Phone: 270-491-0718
  • Fax: 270-325-3182
Mailing address:
  • Phone: 270-491-0718
  • Fax: 270-325-3182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number500204
License Number StateKY

VIII. Authorized Official

Name: VICTORIA SOTO
Title or Position: OWNER
Credential:
Phone: 270-491-0718