Provider Demographics
NPI:1851579577
Name:GOODMAN,S HOME HEALTH
Entity Type:Organization
Organization Name:GOODMAN,S HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AFRICA
Authorized Official - Middle Name:TOPAZE
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:864-567-3549
Mailing Address - Street 1:206 MARLENA AVE
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-9198
Mailing Address - Country:US
Mailing Address - Phone:864-567-3549
Mailing Address - Fax:
Practice Address - Street 1:206 MARLENA AVE
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-9198
Practice Address - Country:US
Practice Address - Phone:864-567-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health