Healthcare Provider Details

I. General information

NPI: 1679695662
Provider Name (Legal Business Name): GENTLE HEARTS HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 04/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 BRIARGATE CIR
COLUMBIA SC
29210-6539
US

IV. Provider business mailing address

1034 BRIARGATE CIR
COLUMBIA SC
29210-6539
US

V. Phone/Fax

Practice location:
  • Phone: 803-750-6200
  • Fax: 803-750-2355
Mailing address:
  • Phone: 803-750-6200
  • Fax: 803-750-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNC

VIII. Authorized Official

Name: MR. SIRCHANNIE WILLIAM SHEFFIELD
Title or Position: VICE PRESIDENT
Credential:
Phone: 803-750-6200