Provider Demographics
NPI:1407814700
Name:HOME REMEDIES ADULT CARE SERVICES
Entity Type:Organization
Organization Name:HOME REMEDIES ADULT CARE SERVICES
Other - Org Name:CARING HANDS PROFESSIONAL CAREGIVERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LASONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-424-2650
Mailing Address - Street 1:2030A LYTTLETON ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-2412
Mailing Address - Country:US
Mailing Address - Phone:803-424-2650
Mailing Address - Fax:803-424-2658
Practice Address - Street 1:2030A LYTTLETON ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-2412
Practice Address - Country:US
Practice Address - Phone:803-424-2650
Practice Address - Fax:803-424-2658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20060304251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEXO689Medicaid
SC=========OtherFEDERAL ID NUMBER