MEDICARE: CLASSIE HANDS HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1578354858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLASSIE HANDS HOME CARE LLC

Provider Business Mailing Address
First Line	:	2555 REPSDORPH RD APT 1426
Second Line	:
City	:	SEABROOK
State	:	TX
Zip	:	77586-6526
Country	:	US
Telephone Number	:	346-222-0612
Fax Number	:

Provider Business Practice Location Address
First Line	:	16821 BUCCANEER LN STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-2512
Country	:	US
Telephone Number	:	346-222-0612
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DESHAWN DENESE MITCHELL
Credential	:
Telephone Number	:	832-754-6445

Provider Enumeration Date	:	05/15/2025
Last Update Date	:	05/15/2025

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