Healthcare Provider Details

I. General information

NPI: 1700530565
Provider Name (Legal Business Name): HEALING HANDS HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 HIGHWAY 80 W STE R
CLINTON MS
39056-4108
US

IV. Provider business mailing address

604 HIGHWAY 80 W STE R
CLINTON MS
39056-4108
US

V. Phone/Fax

Practice location:
  • Phone: 601-209-8444
  • Fax:
Mailing address:
  • Phone: 601-209-8444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE HARVIN
Title or Position: OWNER
Credential:
Phone: 601-209-8444