=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255111571
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALING HANDS HOME HEALTH CARE AGENCY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2023
-----------------------------------------------------
Last Update Date | 10/03/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11983 TAMIAMI TRL N STE 163
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34110-1610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-631-8112
-----------------------------------------------------
Fax | 239-591-5993
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11983 TAMIAMI TRL N STE 163
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34110-1610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-631-8112
-----------------------------------------------------
Fax | 239-591-5993
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. LIGIA L CHEDIAK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 239-631-8112
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------