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General NPI Number Information
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NPI Number | 1457110389
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Entity Type | Organization
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Legal Business Name | GENTLECARE SERVICES
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 400 CONGRESS ST #310
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City | PORTLAND
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State | ME
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Zip | 04101-3592
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Country | US
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Telephone | 207-300-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 1913 13TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-2018
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YAHYE AHMED MOHAMED
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Credential |
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Telephone | 612-232-6930
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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 |
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License Number State |
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