Healthcare Provider Details

I. General information

NPI: 1730607474
Provider Name (Legal Business Name): GENTLE HANDS DIRECT CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6659 SCHAEFER HWY STE. 103
DEARBORN MI
48128
US

IV. Provider business mailing address

6659 SCHAEFER RD STE 103
DEARBORN MI
48126-1812
US

V. Phone/Fax

Practice location:
  • Phone: 248-252-4568
  • Fax: 734-629-1585
Mailing address:
  • Phone: 248-252-4568
  • Fax: 734-629-1585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateMI

VIII. Authorized Official

Name: JOHN DAVIS JR.
Title or Position: OWNER
Credential:
Phone: 248-252-4568