MEDICARE: GIFTED HANDS CLEANING 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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1790504363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GIFTED HANDS CLEANING LLC

Provider Business Mailing Address
First Line	:	2446 CATALPA DRIVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-2155
Country	:	US
Telephone Number	:	937-668-3986
Fax Number	:

Provider Business Practice Location Address
First Line	:	2446 CATALPA DRIVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-2155
Country	:	US
Telephone Number	:	937-668-3986
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANGELA MICHELLE TIMPSON
Credential	:
Telephone Number	:	937-668-3986

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	10/09/2024

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