Healthcare Provider Details

I. General information

NPI: 1811122617
Provider Name (Legal Business Name): D-LITE HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1943 BOYD RD
SCRANTON SC
29591-5835
US

IV. Provider business mailing address

PO BOX 414 1943 BOYD RD
SCRANTON SC
29591-0414
US

V. Phone/Fax

Practice location:
  • Phone: 843-325-5590
  • Fax: 843-210-7543
Mailing address:
  • Phone: 843-325-5590
  • Fax: 843-210-7543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: DON E WILSON
Title or Position: CEO
Credential: NREMT-P, CNA
Phone: 843-325-5590