Healthcare Provider Details

I. General information

NPI: 1881515286
Provider Name (Legal Business Name): HAVENLEIGH HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 MAXWELL DR
EASLEY SC
29642-8426
US

IV. Provider business mailing address

205 MAXWELL DR
EASLEY SC
29642-8426
US

V. Phone/Fax

Practice location:
  • Phone: 864-517-5645
  • Fax:
Mailing address:
  • Phone: 864-517-5645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: VANIESSA MARIE WILLIAMS-FRAY
Title or Position: OWNER/ADMINISTRATOR
Credential: RN, BSN, MPH
Phone: 864-517-5645