Provider Demographics
NPI:1861011132
Name:CAST YOUR CARE HEALTH CARE, LLC
Entity Type:Organization
Organization Name:CAST YOUR CARE HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-606-3327
Mailing Address - Street 1:9005 TWO NOTCH RD STE 12
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-5850
Mailing Address - Country:US
Mailing Address - Phone:803-606-3327
Mailing Address - Fax:
Practice Address - Street 1:9005 TWO NOTCH RD STE 12
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-5850
Practice Address - Country:US
Practice Address - Phone:803-606-3327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty