Healthcare Provider Details

I. General information

NPI: 1053598532
Provider Name (Legal Business Name): GENTLE HANDS HOME HEATHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2008
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 KEMPSVILLE RD STE 2
VIRGINIA BCH VA
23464-2723
US

IV. Provider business mailing address

810 KEMPSVILLE RD STE 2
VIRGINIA BEACH VA
23464-2723
US

V. Phone/Fax

Practice location:
  • Phone: 757-495-1451
  • Fax:
Mailing address:
  • Phone: 757-495-1451
  • Fax: 757-495-1453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberPORTSMOUTH23
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberPORTSMOUTH
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberPORTSMOUTH23
License Number StateVA

VIII. Authorized Official

Name: MELISSA KAYE ELLIS EL
Title or Position: CEO
Credential: B.A., M.S.
Phone: 757-495-1451