Provider Demographics
NPI:1578032579
Name:ANGELIC HANDS OF THE CAROLINAS HOMECARE
Entity Type:Organization
Organization Name:ANGELIC HANDS OF THE CAROLINAS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-747-3932
Mailing Address - Street 1:17 BRISBANE DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN INN
Mailing Address - State:SC
Mailing Address - Zip Code:29644-1768
Mailing Address - Country:US
Mailing Address - Phone:864-558-1287
Mailing Address - Fax:
Practice Address - Street 1:17 BRISBANE DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN INN
Practice Address - State:SC
Practice Address - Zip Code:29644-1768
Practice Address - Country:US
Practice Address - Phone:864-558-1287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care