Healthcare Provider Details

I. General information

NPI: 1225601644
Provider Name (Legal Business Name): GENTLE HANDS WITH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 07/24/2021
Certification Date: 07/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5430 APRIL FOREST CV
MEMPHIS TN
38141-0567
US

IV. Provider business mailing address

5430 APRIL FOREST CV
MEMPHIS TN
38141-0567
US

V. Phone/Fax

Practice location:
  • Phone: 629-239-3401
  • Fax:
Mailing address:
  • Phone: 629-239-3401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. KENDRA MOTON
Title or Position: OWNER
Credential:
Phone: 629-239-3401