MEDICARE: GOD'S HELPING HANDS PERSONAL SERVICES, 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	172A00000X	Driver
2	342000000X	Transportation Network Company
3	253Z00000X	In Home Supportive Care Agency	08011588	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689825887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOD'S HELPING HANDS PERSONAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	3906 W 86TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1701
Country	:	US
Telephone Number	:	231-295-8727
Fax Number	:	317-295-8722

Provider Business Practice Location Address
First Line	:	3906 W 86TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-1701
Country	:	US
Telephone Number	:	317-295-8727
Fax Number	:	317-295-8722

Authorized Official
Title or Position	:	OWNER
Name	:	KENYATTA MITCHELL
Credential	:
Telephone Number	:	317-295-8727

Provider Enumeration Date	:	10/06/2008
Last Update Date	:	07/02/2024

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