MEDICARE: BE GENTLE HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1760356976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE GENTLE HOME CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	2943 PRAIRIE OAK BLVD
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-4587
Country	:	US
Telephone Number	:	214-519-9831
Fax Number	:

Provider Business Practice Location Address
First Line	:	2943 PRAIRIE OAK BLVD
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-4587
Country	:	US
Telephone Number	:	971-708-9143
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR / MANAGING MEMBER
Name	:	ABDIFATAH MOHAMED AHMED
Credential	:
Telephone Number	:	214-519-9831

Provider Enumeration Date	:	10/01/2025
Last Update Date	:	03/21/2026

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