Provider Demographics
NPI:1831798545
Name:ENLIGHTENED HOME CARE LLC
Entity type:Organization
Organization Name:ENLIGHTENED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:864-202-6968
Mailing Address - Street 1:309 SE MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2696
Mailing Address - Country:US
Mailing Address - Phone:864-202-6968
Mailing Address - Fax:
Practice Address - Street 1:309 SE MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2696
Practice Address - Country:US
Practice Address - Phone:864-202-6968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251V00000XAgenciesVoluntary or Charitable
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX1889Medicaid