Healthcare Provider Details

I. General information

NPI: 1497178123
Provider Name (Legal Business Name): GIVE ME A BREAK-NOW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 SHADOW GREY CT
COLUMBIA SC
29223-8238
US

IV. Provider business mailing address

6 SHADOW GREY CT
COLUMBIA SC
29223-8238
US

V. Phone/Fax

Practice location:
  • Phone: 803-315-3768
  • Fax:
Mailing address:
  • Phone: 803-315-3768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMMY GRAY WIMBERLY
Title or Position: OWNER AND MANAGER
Credential:
Phone: 803-315-3768