Healthcare Provider Details

I. General information

NPI: 1609054261
Provider Name (Legal Business Name): GENTLE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 THIMBLE SHOALS BLVD SUITE J
NEWPORT NEWS VA
23606-3563
US

IV. Provider business mailing address

751 THIMBLE SHOALS BLVD SUITE J
NEWPORT NEWS VA
23606-3563
US

V. Phone/Fax

Practice location:
  • Phone: 757-873-4555
  • Fax: 757-873-4587
Mailing address:
  • Phone: 757-873-4555
  • Fax: 757-873-4587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberHCO- 08357
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberHCO-08357
License Number StateVA

VIII. Authorized Official

Name: MRS. BRENDA R HOLMES I
Title or Position: PRESIDENT / OWNER
Credential:
Phone: 757-873-4555