Healthcare Provider Details

I. General information

NPI: 1093367047
Provider Name (Legal Business Name): LOVELY DAY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 LINCOLNSHIRE DR
GEORGETOWN SC
29440-4514
US

IV. Provider business mailing address

1410 HIGHMARKET ST # 225
GEORGETOWN SC
29440-3274
US

V. Phone/Fax

Practice location:
  • Phone: 843-400-2500
  • Fax: 843-996-3377
Mailing address:
  • Phone: 843-400-2500
  • Fax: 843-996-3377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: YEGIDE ABEO WHITE
Title or Position: COORDINATOR
Credential:
Phone: 843-400-2500