Healthcare Provider Details

I. General information

NPI: 1669066957
Provider Name (Legal Business Name): PASSIONATE HANDS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 N HIGHWAY 52 STE I
MONCKS CORNER SC
29461-3926
US

IV. Provider business mailing address

219 N HIGHWAY 52 STE I
MONCKS CORNER SC
29461-3926
US

V. Phone/Fax

Practice location:
  • Phone: 843-779-4012
  • Fax:
Mailing address:
  • Phone: 843-779-4012
  • 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: MS. KHALILAH RENEE PARKER
Title or Position: OWNER
Credential:
Phone: 843-779-4012