=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811705643
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUMBLING HANDS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/26/2024
-----------------------------------------------------
Last Update Date | 12/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2076 PETERSEN WAY
-----------------------------------------------------
City | SUFFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23434-2373
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-517-6361
-----------------------------------------------------
Fax | 757-517-3069
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2076 PETERSEN WAY
-----------------------------------------------------
City | SUFFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23434-2373
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-517-6361
-----------------------------------------------------
Fax | 757-517-3069
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DARRAIN CASPER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-517-6361
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------