MEDICARE: GENTLE HANDS HOME HEATHCARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	PORTSMOUTH23	VA
2	251J00000X	Nursing Care Agency	PORTSMOUTH	VA
3	385H00000X	Respite Care
4	251E00000X	Home Health Agency	PORTSMOUTH23	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053598532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE HANDS HOME HEATHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	810 KEMPSVILLE RD STE 2
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-2723
Country	:	US
Telephone Number	:	757-495-1451
Fax Number	:	757-495-1453

Provider Business Practice Location Address
First Line	:	810 KEMPSVILLE RD STE 2
Second Line	:
City	:	VIRGINIA BCH
State	:	VA
Zip	:	23464-2723
Country	:	US
Telephone Number	:	757-495-1451
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MELISSA KAYE ELLIS EL
Credential	:	B.A., M.S.
Telephone Number	:	757-495-1451

Provider Enumeration Date	:	01/27/2008
Last Update Date	:	07/14/2015

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