Provider Demographics
NPI:1265277909
Name:CAROLINA SUNRISE HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:CAROLINA SUNRISE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRYSTAL
Authorized Official - Middle Name:FELICIA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CNA, PBT(ASCP)
Authorized Official - Phone:864-278-5692
Mailing Address - Street 1:110 SALEM STREET
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-4049
Mailing Address - Country:US
Mailing Address - Phone:864-278-5692
Mailing Address - Fax:864-658-4457
Practice Address - Street 1:110 SALEM STREET
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-4049
Practice Address - Country:US
Practice Address - Phone:864-278-5692
Practice Address - Fax:864-658-4457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health