Provider Demographics
NPI:1457697633
Name:HOME LAND SENIOR CARE
Entity Type:Organization
Organization Name:HOME LAND SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-403-8474
Mailing Address - Street 1:652 BUSH RIVER RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-7521
Mailing Address - Country:US
Mailing Address - Phone:803-403-8474
Mailing Address - Fax:877-661-9669
Practice Address - Street 1:652 BUSH RIVER RD
Practice Address - Street 2:211
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-7521
Practice Address - Country:US
Practice Address - Phone:803-403-8474
Practice Address - Fax:877-661-9669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
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No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty