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General NPI Number Information
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NPI Number | 1801691597
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Entity Type | Organization
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Legal Business Name | GENTLEMIND SKILLED SERVICES LLC
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 1449 E LEWIS ST STE 2
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City | FORT WAYNE
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State | IN
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Zip | 46803-2000
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Country | US
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Telephone | 260-271-9533
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Fax | 260-239-6001
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Provider Business Mailing Address
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Address Line | 1449 E LEWIS ST STE 2
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City | FORT WAYNE
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State | IN
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Zip | 46803-2000
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Country | US
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Telephone | 260-271-9533
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Fax | 260-239-6001
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Authorized Official
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Title or Position | CEO
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Name | DORIS OKOLI
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Credential |
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Telephone | 610-416-5241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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