Healthcare Provider Details

I. General information

NPI: 1114792868
Provider Name (Legal Business Name): A CARING SAMARITAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 HONEYSUCKLE RD
ST MATTHEWS SC
29135-8086
US

IV. Provider business mailing address

288 HONEYSUCKLE RD
ST MATTHEWS SC
29135-8086
US

V. Phone/Fax

Practice location:
  • Phone: 561-386-3297
  • Fax:
Mailing address:
  • Phone: 561-386-3297
  • Fax:

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 Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BETTY HOUSER
Title or Position: DIRECTOR
Credential:
Phone: 561-386-3297