Provider Demographics
NPI:1235693797
Name:NCSC HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:NCSC HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDNT
Authorized Official - Prefix:
Authorized Official - First Name:YUSUF
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-792-9211
Mailing Address - Street 1:1565 EBENEZER RD STE 111
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3421
Mailing Address - Country:US
Mailing Address - Phone:803-792-9211
Mailing Address - Fax:803-693-5465
Practice Address - Street 1:1565 EBENEZER RD STE 111
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3421
Practice Address - Country:US
Practice Address - Phone:803-792-9211
Practice Address - Fax:803-693-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1460Medicaid
SCIHCP-0596OtherDHEC