Provider Demographics
NPI:1144853227
Name:GIFTED HANDS WITH A HEART INC
Entity type:Organization
Organization Name:GIFTED HANDS WITH A HEART INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:LATOYA
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-244-1044
Mailing Address - Street 1:111 AVENUE R NE STE 101
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33881-2472
Mailing Address - Country:US
Mailing Address - Phone:863-604-5560
Mailing Address - Fax:863-299-8134
Practice Address - Street 1:111 AVENUE R NE STE 101
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33881-2472
Practice Address - Country:US
Practice Address - Phone:844-244-1044
Practice Address - Fax:863-299-8134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104396400Medicaid