=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871049478
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANOINTED HANDS HOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2016
-----------------------------------------------------
Last Update Date | 09/01/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5672 PINE CHASE DRIVE 6
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-459-5086
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5672 PINE CHASE DRIVE 6
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-459-5086
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINSITRATOR
-----------------------------------------------------
Name | NATOY BAKER
-----------------------------------------------------
Credential | BS, HCM
-----------------------------------------------------
Telephone | 407-459-5086
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 234516
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------