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General NPI Number Information
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NPI Number | 1497186290
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Entity Type | Organization
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Legal Business Name | GOOD HANDS PROVIDER SERVICES LLC
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 3978 FOREST EDGE DR
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City | GAHANNA
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State | OH
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Zip | 43230-1018
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Country | US
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Telephone | 614-929-1784
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Fax |
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Provider Business Mailing Address
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Address Line | 3978 FOREST EDGE DR
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City | GAHANNA
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State | OH
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Zip | 43230-1018
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Country | US
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Telephone | 614-929-1784
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS HAJA MARIE CONTEH
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Credential | DIRECTOR
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Telephone | 614-929-1784
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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 | PN 119583
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License Number State | OH
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