MEDICARE: HEALING HANDS SUPPORTIVE CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1962368944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HANDS SUPPORTIVE CARE LLC

Provider Business Mailing Address
First Line	:	5649 W WOOD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-6324
Country	:	US
Telephone Number	:	262-993-1444
Fax Number	:

Provider Business Practice Location Address
First Line	:	5649 W WOOD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-6324
Country	:	US
Telephone Number	:	262-993-1444
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	YUTASHA D WILKS
Credential	:
Telephone Number	:	262-993-1444

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	01/02/2026

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