Provider Demographics
NPI:1336508530
Name:MECA HOME HEALTH, LLC
Entity Type:Organization
Organization Name:MECA HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MHSA EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUNGIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-494-3986
Mailing Address - Street 1:415 SAVANNAH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485
Mailing Address - Country:US
Mailing Address - Phone:843-494-3986
Mailing Address - Fax:
Practice Address - Street 1:415 SAVANNAH RIVER RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485
Practice Address - Country:US
Practice Address - Phone:843-494-3986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health