Healthcare Provider Details

I. General information

NPI: 1720876584
Provider Name (Legal Business Name): HEALING HANDS 4U2 HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 05/04/2025
Certification Date: 05/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 FOLK ST
POTTERVILLE MI
48876-9515
US

IV. Provider business mailing address

106 FOLK ST
POTTERVILLE MI
48876-9515
US

V. Phone/Fax

Practice location:
  • Phone: 517-894-7624
  • Fax:
Mailing address:
  • Phone: 517-894-7624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ISAIAH ROBLES
Title or Position: CEO
Credential:
Phone: 517-894-7624