Provider Demographics
NPI:1134633381
Name:IN-HOME COMPASSIONATE CARE SERVICE, INC.
Entity type:Organization
Organization Name:IN-HOME COMPASSIONATE CARE SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-998-4883
Mailing Address - Street 1:3009 CHURCH ST STE A
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5983
Mailing Address - Country:US
Mailing Address - Phone:843-249-9200
Mailing Address - Fax:
Practice Address - Street 1:3009 CHURCH ST STE A
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5983
Practice Address - Country:US
Practice Address - Phone:843-249-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3913253Z00000X, 385H00000X
SCIHCP-0762385H00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care