Organization
GIFTED DIVERSITY HANDS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAQUILLA RENEE HANNON CARE PROVIDER (OWNER)
(414) 552-3291
Entity
Organization
Contact information
Practice address
1728 W WRIGHT ST, MILWAUKEE, WI 53206-2043
(262) 696-9711
(262) 999-0150
Mailing address
3940 W LISBON AVE APT 310, MILWAUKEE, WI 53208-1883
(414) 552-3291
(262) 999-0150
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
374U00000X
Home Health Aide
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17571
—
WI
Enumeration date
07/11/2023
Last updated
08/28/2023
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