Healthcare Provider Details

I. General information

NPI: 1619343894
Provider Name (Legal Business Name): TOUCHING HEARTS HOME CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 KELLEY ST
LAKE CITY SC
29560-2415
US

IV. Provider business mailing address

215 KELLEY ST
LAKE CITY SC
29560-2415
US

V. Phone/Fax

Practice location:
  • Phone: 843-699-9390
  • Fax: 843-699-9400
Mailing address:
  • Phone: 843-699-9390
  • Fax: 843-699-9400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number8643
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SHEVONNE THOMPSON
Title or Position: OWNER
Credential: RN
Phone: 843-496-6472