Healthcare Provider Details

I. General information

NPI: 1497384317
Provider Name (Legal Business Name): ADORE LIVING EXCELLENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 BELGRAVE DR
BLYTHEWOOD SC
29016-8872
US

IV. Provider business mailing address

PO BOX 292316
COLUMBIA SC
29229-0039
US

V. Phone/Fax

Practice location:
  • Phone: 803-727-3209
  • Fax:
Mailing address:
  • Phone: 803-904-4027
  • Fax: 803-859-1655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. LAMAR ALEXANDER
Title or Position: CO-OWNER
Credential:
Phone: 803-727-3209