MEDICARE: GOD'S HANDIWORK LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	343800000X	Secured Medical Transport (VAN)
2	343900000X	Non-emergency Medical Transport (VAN)
3	374U00000X	Home Health Aide
4	385H00000X	Respite Care
5	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1851060578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOD'S HANDIWORK LLC

Provider Business Mailing Address
First Line	:	3326 S SW LOOP 323
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-9237
Country	:	US
Telephone Number	:	903-617-1502
Fax Number	:	903-630-1074

Provider Business Practice Location Address
First Line	:	3326 S SW LOOP 323
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75701-9237
Country	:	US
Telephone Number	:	903-617-1502
Fax Number	:	903-630-1074

Authorized Official
Title or Position	:	MANAGER/OWNER
Name	:	SEQUOIA SANA' HOLMES
Credential	:	LVN
Telephone Number	:	936-433-7271

Provider Enumeration Date	:	09/07/2021
Last Update Date	:	03/14/2024

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Directions to “GOD'S HANDIWORK LLC ” Practice Location

Language	Start Address	Practice Location

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