Provider Demographics
NPI:1831420447
Name:GENTLE HANDS HOME HEALTH AGENCY, INC.
Entity type:Organization
Organization Name:GENTLE HANDS HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-339-0409
Mailing Address - Street 1:6885 CLIFFDALE ROAD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2834
Mailing Address - Country:US
Mailing Address - Phone:910-339-0409
Mailing Address - Fax:910-339-0412
Practice Address - Street 1:6885 CLIFFDALE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2833
Practice Address - Country:US
Practice Address - Phone:910-339-0409
Practice Address - Fax:910-339-0412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care