Provider Demographics
NPI:1407397821
Name:PASSIONATE CARE
Entity Type:Organization
Organization Name:PASSIONATE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:CLEONADA
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-616-5324
Mailing Address - Street 1:868 DILLARD RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7074
Mailing Address - Country:US
Mailing Address - Phone:803-616-5324
Mailing Address - Fax:
Practice Address - Street 1:868 DILLARD RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7074
Practice Address - Country:US
Practice Address - Phone:803-616-5324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC385HR2065X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child