Healthcare Provider Details

I. General information

NPI: 1952024523
Provider Name (Legal Business Name): GENTLE CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5304 EXETER PL
WHITE PLAINS MD
20695-3198
US

IV. Provider business mailing address

5304 EXETER PL
WHITE PLAINS MD
20695-3198
US

V. Phone/Fax

Practice location:
  • Phone: 301-257-3029
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: MELINDA PEACOCK
Title or Position: MISS
Credential:
Phone: 301-257-3029