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General NPI Number Information
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NPI Number | 1093136103
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Entity Type | Organization
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Legal Business Name | GENTLE HANDS HOME SERVICES, LLC
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 5474 CAIRN HWY
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City | KEWADIN
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State | MI
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Zip | 49648-9135
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Country | US
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Telephone | 231-498-2246
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Fax | 231-498-2031
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Provider Business Mailing Address
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Address Line | 5474 CAIRN HWY
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City | KEWADIN
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State | MI
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Zip | 49648-9135
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Country | US
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Telephone | 231-498-2246
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Fax | 231-498-2031
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH ANN RUDISEL
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Credential | LPN
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Telephone | 231-498-2246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | E21337
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License Number State | MI
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