Healthcare Provider Details

I. General information

NPI: 1932413127
Provider Name (Legal Business Name): ADDUS HEALTHCARE (SOUTH CAROLINA), INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 PLEASANT HOME RD STE 1
AUGUSTA GA
30907-0518
US

IV. Provider business mailing address

801 WARRENVILLE RD STE 800
LISLE IL
60532-0912
US

V. Phone/Fax

Practice location:
  • Phone: 706-774-0042
  • Fax: 855-807-6943
Mailing address:
  • Phone: 630-296-3400
  • Fax: 630-487-2713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MR. DARBY ANDERSON
Title or Position: NATIONAL CONTRACTS
Credential:
Phone: 630-296-3443