Provider Demographics
NPI:1588036800
Name:DEVOTED CARE AND TRANSITION SERVICES-HOSPICE, LLC
Entity type:Organization
Organization Name:DEVOTED CARE AND TRANSITION SERVICES-HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBALE
Authorized Official - Middle Name:LANETTE
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-764-1163
Mailing Address - Street 1:1107 BELLEVIEW ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-1810
Mailing Address - Country:US
Mailing Address - Phone:803-764-1163
Mailing Address - Fax:
Practice Address - Street 1:1107 BELLEVIEW ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-1810
Practice Address - Country:US
Practice Address - Phone:803-764-1163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service