1568900330 NPI number — HEALING HANDS SERVICES INC

Table of content: (NPI 1568900330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568900330 NPI number — HEALING HANDS SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING HANDS SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568900330
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5930 HOHMAN AVE STE 212
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMMOND
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46320-3051
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-937-2890
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5930 HOHMAN AVE STE 212
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMMOND
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46320-3051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-937-2890
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALAO
Authorized Official First Name:
AYOWALE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
312-719-3339

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374U00000X , with the licence number: 013887 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X , with the licence number: 013887 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376K00000X , with the licence number: 013887 , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)