Healthcare Provider Details

I. General information

NPI: 1225388168
Provider Name (Legal Business Name): HOPES HAVEN HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 N. MAIN ST.
LAKE VIEW SC
29563-0000
US

IV. Provider business mailing address

1937 WARD STORE RD
FAIRMONT NC
28340-6451
US

V. Phone/Fax

Practice location:
  • Phone: 843-759-2500
  • Fax:
Mailing address:
  • Phone: 843-759-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LINDA SEALEY
Title or Position: OWNER
Credential:
Phone: 910-733-6243