Provider Demographics
NPI:1013416692
Name:GARDEN OF PRAYER HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:GARDEN OF PRAYER HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-567-1144
Mailing Address - Street 1:3401 HIGHWAY 153 STE D
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-6760
Mailing Address - Country:US
Mailing Address - Phone:864-263-3609
Mailing Address - Fax:864-203-5700
Practice Address - Street 1:3401 HIGHWAY 153 STE D
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-6760
Practice Address - Country:US
Practice Address - Phone:864-263-3609
Practice Address - Fax:864-203-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health