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General NPI Number Information
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NPI Number | 1831367705
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Entity Type | Organization
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Legal Business Name | GENTLE TOUCH HOMECARE SERVICES
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 2103 W 4TH ST
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City | HATTIESBURG
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State | MS
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Zip | 39401-4702
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Country | US
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Telephone | 601-554-0691
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Fax | 601-554-0690
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Provider Business Mailing Address
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Address Line | 2103 W 4TH ST
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City | HATTIESBURG
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State | MS
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Zip | 39401-4702
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Country | US
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Telephone | 601-554-0691
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Fax | 601-554-0690
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. TANYA GLADONDREIA RIDEOUT
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Credential |
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Telephone | 601-554-0691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 06932519
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License Number State | MS
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