Healthcare Provider Details

I. General information

NPI: 1336932326
Provider Name (Legal Business Name): OUTSTRETCHED HANDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 LYDE AVE APT 1093
LOUISA VA
23093-6511
US

IV. Provider business mailing address

301 LYDE AVE APT 1003301
LOUISA VA
23093-6513
US

V. Phone/Fax

Practice location:
  • Phone: 804-615-3370
  • Fax: 540-500-5901
Mailing address:
  • Phone: 804-615-3370
  • Fax: 560-500-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: JOAN RENEE COOK
Title or Position: OWNER
Credential: CNA
Phone: 804-615-3370