MEDICARE: GENTLE HANDS HOME HEALTHCARE 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	251G00000X	Community Based Hospice Care Agency		VA
2	251E00000X	Home Health Agency		VA

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	:	1841583846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE HANDS HOME HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	4410 CLAIBORNE SQ E
Second Line	:	334
City	:	HAMPTON
State	:	VA
Zip	:	23666-2071
Country	:	US
Telephone Number	:	757-241-0341
Fax Number	:	866-667-2490

Provider Business Practice Location Address
First Line	:	4410 CLAIBORNE SQ E
Second Line	:	334
City	:	HAMPTON
State	:	VA
Zip	:	23666-2071
Country	:	US
Telephone Number	:	757-241-0341
Fax Number	:	866-667-2490

Authorized Official
Title or Position	:	CEO
Name	:	MELISSA KAYE ELLIS EL
Credential	:	B.A., M.S.
Telephone Number	:	757-241-0341

Provider Enumeration Date	:	05/24/2011
Last Update Date	:	05/24/2011

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