Healthcare Provider Details

I. General information

NPI: 1548131436
Provider Name (Legal Business Name): JANICE MARIE KENDRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415B CHURCH ST
PENDLETON SC
29670-1918
US

IV. Provider business mailing address

415B CHURCH ST
PENDLETON SC
29670-1918
US

V. Phone/Fax

Practice location:
  • Phone: 864-651-2440
  • Fax: 864-502-2040
Mailing address:
  • Phone: 864-651-2440
  • Fax: 864-502-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: