MEDICARE: FOREVER LOVING HANDS, INC

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	172V00000X	Community Health Worker

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	:	1790640852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREVER LOVING HANDS, INC

Provider Business Mailing Address
First Line	:	1903 PLOVER AVE APT A
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34949-3446
Country	:	US
Telephone Number	:	772-940-3736
Fax Number	:	772-264-7695

Provider Business Practice Location Address
First Line	:	1903 PLOVER AVE APT A
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34949-3446
Country	:	US
Telephone Number	:	772-940-3736
Fax Number	:	772-264-7695

Authorized Official
Title or Position	:	OWNER
Name	:	CORLISS Y PHILLIPS
Credential	:	LPN
Telephone Number	:	772-940-3736

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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Directions to “FOREVER LOVING HANDS, INC ” Practice Location

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