=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720700693
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GENTLE CARING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2022
-----------------------------------------------------
Last Update Date | 09/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4626 WILLOW POND CT E
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33417-8242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-340-3477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 221211
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33422-1211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-333-4295
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF EXECUTIVE OFFICER
-----------------------------------------------------
Name | MR. NEWTON KELLY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 772-333-4295
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------