Provider Demographics
NPI:1356091276
Name:DEDICATED HOME CARE
Entity Type:Organization
Organization Name:DEDICATED HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ELICEF
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-598-8754
Mailing Address - Street 1:417 JEFFERIES LN APT 8
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-2278
Mailing Address - Country:US
Mailing Address - Phone:843-598-8754
Mailing Address - Fax:843-799-1149
Practice Address - Street 1:3658 S IRBY ST STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-5225
Practice Address - Country:US
Practice Address - Phone:843-702-0018
Practice Address - Fax:843-799-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1923Medicaid