Healthcare Provider Details

I. General information

NPI: 1790497527
Provider Name (Legal Business Name): CHARITY FIRST HOME CARE LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2022
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 BUCKWALTER PKWY STE 2E
BLUFFTON SC
29910-4129
US

IV. Provider business mailing address

462 CAMPUS LN
BLUFFTON SC
29909-4656
US

V. Phone/Fax

Practice location:
  • Phone: 678-573-9073
  • Fax:
Mailing address:
  • Phone: 843-705-1021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: NICOLE MCCLELLAN
Title or Position: ADMIN
Credential:
Phone: 678-573-9073