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NPI Code Detail

MEDICARE: GENTLEMIND HEALTH SERVICES

MEDICARE: GENTLEMIND HEALTH SERVICES
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
1251E00000XHome Health Agency
2253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1629679170
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENTLEMIND HEALTH SERVICES
Provider Business Mailing Address
First Line : 1449 E LEWIS ST STE 2
Second Line :
City : FORT WAYNE
State : IN
Zip : 46803-2000
Country : US
Telephone Number : 260-271-9533
Fax Number : 260-239-6001
Provider Business Practice Location Address
First Line : 1449 E LEWIS ST STE 2
Second Line :
City : FORT WAYNE
State : IN
Zip : 46803-2000
Country : US
Telephone Number : 260-271-9533
Fax Number : 260-239-6001
Authorized Official
Title or Position : FOUNDER/CEO
Name : DORIS OKOLI
Credential :
Telephone Number : 610-416-5241
Provider Enumeration Date : 11/02/2020
Last Update Date : 10/18/2024

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Directions to “GENTLEMIND HEALTH SERVICES ” Practice Location

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