MEDICARE: GIFTED HANDS ENTERPRISE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1780284786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFTED HANDS ENTERPRISE, LLC

Provider Business Mailing Address
First Line	:	5202 EMORY MILL RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-7120
Country	:	US
Telephone Number	:	832-795-8982
Fax Number	:	832-514-3646

Provider Business Practice Location Address
First Line	:	5202 EMORY MILL RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-7120
Country	:	US
Telephone Number	:	832-795-8982
Fax Number	:	832-514-3646

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NDIILOMA MUANA
Credential	:
Telephone Number	:	832-795-9566

Provider Enumeration Date	:	10/28/2020
Last Update Date	:	10/28/2020

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