Healthcare Provider Details

I. General information

NPI: 1467210062
Provider Name (Legal Business Name): HEALING HANDS PREMIER HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 ALGOMA BLVD STE A
OSHKOSH WI
54901-4891
US

IV. Provider business mailing address

146 ALGOMA BLVD STE A
OSHKOSH WI
54901-4891
US

V. Phone/Fax

Practice location:
  • Phone: 920-385-0307
  • Fax:
Mailing address:
  • Phone: 920-385-0307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: KAYLA SPAIN
Title or Position: OWNER/CEO
Credential:
Phone: 262-341-0347