Healthcare Provider Details

I. General information

NPI: 1275138653
Provider Name (Legal Business Name): GIFTED HANDS COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 RUTGERS PL STE LOWER LEVEL
TRENTON NJ
08618-5702
US

IV. Provider business mailing address

10 RUTGERS PL STE LOWER LEVEL
TRENTON NJ
08618-5702
US

V. Phone/Fax

Practice location:
  • Phone: 609-532-0168
  • Fax:
Mailing address:
  • Phone: 347-557-4675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. MANOUCHEKA DESROSIERS
Title or Position: CHIEF EXECUTIVE OFFICER/PRESIDENT
Credential: MD
Phone: 347-557-4675