Provider Demographics
NPI:1295207900
Name:STAY AT HOME OF THE UPSTATE INC
Entity Type:Organization
Organization Name:STAY AT HOME OF THE UPSTATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:STRECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-655-4100
Mailing Address - Street 1:554 MEMORIAL DRIVE EXT STE D
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-1155
Mailing Address - Country:US
Mailing Address - Phone:864-655-4100
Mailing Address - Fax:864-655-4120
Practice Address - Street 1:554 MEMORIAL DRIVE EXT STE D
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1155
Practice Address - Country:US
Practice Address - Phone:864-655-4100
Practice Address - Fax:864-655-4120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care