Healthcare Provider Details

I. General information

NPI: 1457227977
Provider Name (Legal Business Name): JADES ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 FOLLY ROAD BLVD
CHARLESTON SC
29407-7551
US

IV. Provider business mailing address

78 FOLLY ROAD BLVD
CHARLESTON SC
29407-7551
US

V. Phone/Fax

Practice location:
  • Phone: 704-750-1081
  • Fax:
Mailing address:
  • Phone: 704-750-1081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. SHANE FRANKLIN
Title or Position: OWNER
Credential:
Phone: 678-499-8691