MEDICARE: HEALING HANDS MINISTRIES INC.

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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1124884812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HANDS MINISTRIES INC.

Provider Business Mailing Address
First Line	:	3639 HOLMES ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75215-3605
Country	:	US
Telephone Number	:	214-221-0855
Fax Number	:

Provider Business Practice Location Address
First Line	:	3639 HOLMES ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75215-3605
Country	:	US
Telephone Number	:	214-221-0855
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	ROSA N GOMEZ
Credential	:
Telephone Number	:	214-221-0855

Provider Enumeration Date	:	02/21/2024
Last Update Date	:	11/05/2024

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