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General NPI Number Information
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NPI Number | 1053108050
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Entity Type | Organization
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Legal Business Name | GENTLE CARE HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 5750 DOW AVE APT 217
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City | ALEXANDRIA
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State | VA
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Zip | 22304-4069
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Country | US
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Telephone | 703-850-3491
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Fax |
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Provider Business Mailing Address
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Address Line | 5750 DOW AVE APT 217
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City | ALEXANDRIA
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State | VA
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Zip | 22304-4069
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Country | US
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Telephone | 703-850-3491
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GRACE D IVUMBI
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Credential | RRT, PHARMD
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Telephone | 703-850-3491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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