Provider Demographics
NPI:1700487253
Name:TRUE VINE HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:TRUE VINE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-599-0504
Mailing Address - Street 1:TRUE VINE HOME CARE LLC AGENCY
Mailing Address - Street 2:113 SOUTH HIGH WAY 52 STE E
Mailing Address - City:MONCHS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-3956
Mailing Address - Country:US
Mailing Address - Phone:843-461-0635
Mailing Address - Fax:843-761-0636
Practice Address - Street 1:113 S HIGHWAY 52 STE E
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3956
Practice Address - Country:US
Practice Address - Phone:843-761-0635
Practice Address - Fax:843-761-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health