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General NPI Number Information
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NPI Number | 1245400241
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Entity Type | Organization
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Legal Business Name | GENTLE SPIRIT HOME CARE
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 69295 MCCALLUM WAY
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-2990
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Country | US
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Telephone | 760-992-8166
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Fax | 760-992-8166
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Provider Business Mailing Address
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Address Line | 69295 MCCALLUM WAY
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-2990
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Country | US
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Telephone | 760-992-8166
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. CAROLINE ANN BENEDICT
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Credential |
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Telephone | 760-992-8166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 009827
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License Number State | CA
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