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General NPI Number Information
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NPI Number | 1053102376
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Entity Type | Organization
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Legal Business Name | JOLLY HANDS HOME CARE LLC
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 611 N COURTHOUSE RD STE 200J
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-4064
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Country | US
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Telephone | 804-578-5114
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Fax | 804-234-3556
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Provider Business Mailing Address
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Address Line | 611 N COURTHOUSE RD STE 200J
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-4064
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Country | US
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Telephone | 804-578-5114
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Fax | 804-234-3556
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MISHEIKA YANIQUE GAYNOR-ALLISON
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Credential | RN
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Telephone | 614-558-5467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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