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General NPI Number Information
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NPI Number | 1588543193
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Entity Type | Organization
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Legal Business Name | GENTLE SPIRITS HOMECARE LLC
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 4000 HOLLYWOOD BLVD 555-S
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6853
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Country | US
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Telephone | 212-203-6067
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Fax | 212-203-6067
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Provider Business Mailing Address
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Address Line | 4000 HOLLYWOOD BLVD 555-S
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6853
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Country | US
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Telephone | 212-203-6067
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Fax | 212-203-6067
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Authorized Official
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Title or Position | CEO
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Name | MAKVALA NADIRASHVILI
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Credential | AMBR
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Telephone | 305-522-4216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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