MEDICARE: GIFT HOME HEALTH 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	385H00000X	Respite Care
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1598245136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFT HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	102 N KROHN PL STE 210
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-1847
Country	:	US
Telephone Number	:	605-323-9841
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 N KROHN PL STE 210
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-1847
Country	:	US
Telephone Number	:	605-323-9841
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONAL MANAGER
Name	:	DEO RAI
Credential	:
Telephone Number	:	605-323-9841

Provider Enumeration Date	:	08/14/2018
Last Update Date	:	08/14/2018

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Directions to “GIFT HOME HEALTH CARE LLC ” Practice Location

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