Provider Demographics
NPI:1386006898
Name:AJF PERSONAL HOME CARE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:AJF PERSONAL HOME CARE SPECIALISTS, LLC
Other - Org Name:FIRSTLIGHT HOMECARE OF SPARTANBURG COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:S
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-310-6796
Mailing Address - Street 1:145 N CHURCH ST
Mailing Address - Street 2:BTC #53, STE. 106
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-5123
Mailing Address - Country:US
Mailing Address - Phone:864-310-6796
Mailing Address - Fax:
Practice Address - Street 1:145 N CHURCH ST
Practice Address - Street 2:BTC #53, STE. 106
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-5123
Practice Address - Country:US
Practice Address - Phone:864-310-6796
Practice Address - Fax:864-310-6824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1600024174253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care