Provider Demographics
NPI:1861108219
Name:HIS HANDS RESIDENTIAL
Entity type:Organization
Organization Name:HIS HANDS RESIDENTIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:TISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-506-1771
Mailing Address - Street 1:22 YELLOW CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-3114
Mailing Address - Country:US
Mailing Address - Phone:330-506-1771
Mailing Address - Fax:
Practice Address - Street 1:22 YELLOW CREEK CIR
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-3114
Practice Address - Country:US
Practice Address - Phone:330-506-1771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care