Provider Demographics
NPI:1154080794
Name:NIKKICARINGHANDSLLC
Entity Type:Organization
Organization Name:NIKKICARINGHANDSLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DINEKA
Authorized Official - Middle Name:MARCHELL
Authorized Official - Last Name:GILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-495-4104
Mailing Address - Street 1:1401 PHOENIX ST APT 6C
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4113
Mailing Address - Country:US
Mailing Address - Phone:864-495-4104
Mailing Address - Fax:
Practice Address - Street 1:204 A MONTAGUE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-1937
Practice Address - Country:US
Practice Address - Phone:864-495-4104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health