=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295554301
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANOTHER CHANCE HELPING HAND LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2024
-----------------------------------------------------
Last Update Date | 10/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16751 HARLOW ST
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48235-3430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-942-9356
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16751 HARLOW ST
-----------------------------------------------------
City | DETROIT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48235-3430
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-942-9356
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DESHAWN BELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 313-942-9356
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 172V00000X
-----------------------------------------------------
Taxonomy Name | Community Health Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------