MEDICARE: GENTLECARE HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1407611163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLECARE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	2927 EMERALDCUT DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-7638
Country	:	US
Telephone Number	:	614-622-8032
Fax Number	:

Provider Business Practice Location Address
First Line	:	2927 EMERALDCUT DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-7638
Country	:	US
Telephone Number	:	614-622-8032
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PAUL SOUNGFACK
Credential	:
Telephone Number	:	614-622-8032

Provider Enumeration Date	:	02/20/2024
Last Update Date	:	02/20/2024

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