Provider Demographics
NPI:1073187308
Name:WATCHFUL EYES HOME CARE LLC
Entity Type:Organization
Organization Name:WATCHFUL EYES HOME CARE LLC
Other - Org Name:WATCHFUL EYES HOME CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELASHA
Authorized Official - Middle Name:ADE'NIKE
Authorized Official - Last Name:LEFEVRE-WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:803-614-5944
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29116-0729
Mailing Address - Country:US
Mailing Address - Phone:803-614-5944
Mailing Address - Fax:
Practice Address - Street 1:1467 RUSSELL STREET
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-4365
Practice Address - Country:US
Practice Address - Phone:803-860-3441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-20
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health