Healthcare Provider Details
I. General information
NPI: 1811705643
Provider Name (Legal Business Name): HUMBLING HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/26/2024
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2076 PETERSEN WAY
SUFFOLK VA
23434-2373
US
IV. Provider business mailing address
2076 PETERSEN WAY
SUFFOLK VA
23434-2373
US
V. Phone/Fax
- Phone: 757-517-6361
- Fax: 757-517-3069
- Phone: 757-517-6361
- Fax: 757-517-3069
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DARRAIN
CASPER
Title or Position: OWNER
Credential:
Phone: 757-517-6361