Provider Demographics
NPI:1780180422
Name:PERFECTED HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:PERFECTED HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:N
Authorized Official - Last Name:RAIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-233-1726
Mailing Address - Street 1:1205 HORSESUGAR RD
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-8872
Mailing Address - Country:US
Mailing Address - Phone:832-233-1726
Mailing Address - Fax:
Practice Address - Street 1:5580 HIGHWAY 557 STE 101K
Practice Address - Street 2:
Practice Address - City:LAKE WYLIE
Practice Address - State:SC
Practice Address - Zip Code:29710-7359
Practice Address - Country:US
Practice Address - Phone:803-831-6013
Practice Address - Fax:803-831-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0809251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health