MEDICARE: SERVING HANDS, 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1881780187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERVING HANDS, LLC

Provider Business Mailing Address
First Line	:	1159 N WESLEYAN BLVD
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-1840
Country	:	US
Telephone Number	:	252-972-4300
Fax Number	:	252-972-4313

Provider Business Practice Location Address
First Line	:	1159 N WESLEYAN BLVD
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27804-1840
Country	:	US
Telephone Number	:	252-972-4300
Fax Number	:	252-972-4313

Authorized Official
Title or Position	:	MEMBER/DIRECTOR
Name	:	MRS. KIMBERLY M KOZLOWSKI
Credential	:
Telephone Number	:	252-972-4300

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	08/28/2012

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