MEDICARE: REHABILITATING LIVES OF SC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1164372637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABILITATING LIVES OF SC LLC

Provider Business Mailing Address
First Line	:	224 CHERYL RD
Second Line	:
City	:	LORIS
State	:	SC
Zip	:	29569-8701
Country	:	US
Telephone Number	:	843-591-5475
Fax Number	:

Provider Business Practice Location Address
First Line	:	224 CHERYL RD
Second Line	:
City	:	LORIS
State	:	SC
Zip	:	29569-8701
Country	:	US
Telephone Number	:	843-591-5475
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	REGINA DENISE MARTIN
Credential	:	CPR INSTRUCTOR
Telephone Number	:	843-591-5475

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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