Healthcare Provider Details

I. General information

NPI: 1316567829
Provider Name (Legal Business Name): COMPLETE PRO HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4614 WILGROVE MINT HILL RD STE H
MINT HILL NC
28227-3547
US

IV. Provider business mailing address

102 METRO DR STE 9
SPARTANBURG SC
29303-2754
US

V. Phone/Fax

Practice location:
  • Phone: 864-978-6439
  • Fax:
Mailing address:
  • Phone: 864-978-6439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY L HENRY
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 864-978-6439