Provider Demographics
NPI:1366168569
Name:GIFTED HANDS HOME CARE II INC LLC
Entity type:Organization
Organization Name:GIFTED HANDS HOME CARE II INC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-280-4620
Mailing Address - Street 1:1201 CAROLNA PLACE DR # I-102
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-0014
Mailing Address - Country:US
Mailing Address - Phone:803-228-3100
Mailing Address - Fax:
Practice Address - Street 1:1201 CAROLNA PLACE DR # I-102
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-0014
Practice Address - Country:US
Practice Address - Phone:803-228-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care